Autistic individuals report a greater prevalence of physical and mental health difficulties, compared to the general population. This study examines factors which impact physical and mental health in the general population to evaluate whether they potentially underlie this increased prevalence in autistic individuals. We compared twenty-two autistic adults, twenty-three adults reporting symptoms of insomnia, and twenty-one neurotypical adults. The primary factors were sleep quality and insomnia; secondary factors were level of autistic traits, alexithymia, and prosocial behavior. Participants completed self-report measures looking at each of these factors as well as their perceived physical and mental health. Participants also wore an actigraphy watch for up to fourteen days to characterize their sleep behavior. This actigraphy data suggested that autistic adults slept longer than those with symptoms of insomnia and the neurotypical group. Multiple regressions identified which primary or secondary factors were associated with change in perceived physical and mental health. Transdiagnostic dimensional analyses suggested that both lower sleep quality and higher levels of loneliness predicted lower perceived physical and mental health, with the effect being greater for perceived mental health. The addition of secondary factors identified higher levels of alexithymia as a significant predictor of lower levels of perceived mental health but did not improve the model. For the autistic group, no factors were predictive of change in perceived physical health; however, follow-up analyses identified more insomnia symptoms as predicting reduced perceived physical health. Both reduced sleep quality and greater loneliness predicted lower perceived mental health in the autistic adults. More sleep impairment and more symptoms of insomnia also predicted lower perceived mental health but did not better explain this change when included together over when included separately. These study findings suggest that sleep quality and loneliness are salient factors in the mental health of autistic adults and that understanding these, and sleep factors in general, may help to explain mental health challenges in these individuals.



College and Department

Family, Home, and Social Sciences; Psychology



Date Submitted


Document Type





autism, sleep quality, loneliness, physical health, mental health, actigraphy