{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T03:53:29Z","timestamp":1775274809648,"version":"3.50.1"},"reference-count":67,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clocks &amp; Sleep"],"abstract":"<jats:p>Children with Foetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD) experience significantly higher rates of sleep disturbances than their typically developing (TD) peers. Pre-sleep anxiety and waking emotional content is known to affect the content and frequency of nightmares, which can be distressing to children and caregivers. This is the first study to analyse nightmare frequency and content in FASD, and to assess its association with psychometric outcomes. Using online caregiver questionnaires, we assessed reports from 277 caregivers of children with ASD (n = 61), FASD (n = 112), and TD children (n = 104) using the Children\u2019s Sleep Habits Questionnaire (CSHQ), the Child Behaviour Checklist (CBCL), the Spence Children\u2019s Anxiety Scale (SCAS), and the Behaviour Rating Inventory for Executive Functioning (BRIEF). Within the ASD group, 40.3% of caregivers reported their children had nightmares. Within the FASD group, 73.62% of caregivers reported their children had nightmares, and within the TD group, 21.36% of caregivers reported their children had nightmares. Correlation analysis revealed significant associations between anxiety and nightmares, maladaptive behaviour and nightmares, and executive functioning and nightmares in the TD and FASD groups, but not ASD group. This paper adds to the emerging body of work supporting the need for sleep interventions as part of clinical practice with regard to children with ASD and FASD. As a relatively niche but important area of study, this warrants much needed further research.<\/jats:p>","DOI":"10.3390\/clockssleep3030033","type":"journal-article","created":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T03:47:35Z","timestamp":1632282455000},"page":"465-481","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Nightmares in Children with Foetal Alcohol Spectrum Disorders, Autism Spectrum Disorders, and Their Typically Developing Peers"],"prefix":"10.3390","volume":"3","author":[{"given":"Rabya","family":"Mughal","sequence":"first","affiliation":[{"name":"Sleep Education and Research Laboratory, Department of Psychology and Human Development, University College London Institute of Education, London WC1H 0AA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siu Sing","family":"Wong","sequence":"additional","affiliation":[{"name":"Sleep Education and Research Laboratory, Department of Psychology and Human Development, University College London Institute of Education, London WC1H 0AA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6856-0595","authenticated-orcid":false,"given":"Dagmara","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"Sleep Education and Research Laboratory, Department of Psychology and Human Development, University College London Institute of Education, London WC1H 0AA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5633-1859","authenticated-orcid":false,"given":"Elizabeth","family":"Halstead","sequence":"additional","affiliation":[{"name":"Sleep Education and Research Laboratory, Department of Psychology and Human Development, University College London Institute of Education, London WC1H 0AA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"ref_1","unstructured":"Sheldon, S.H., Ferber, R., Kryger, M.H., and Gozal, D. (2014). Principles and Practice of Pediatric Sleep Medicine e-Book, Elsevier Health Sciences. [2nd ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.smrv.2016.06.006","article-title":"Brain imaging findings in idiopathic REM sleep behavior disorder (RBD)\u2013a systematic review on potential biomarkers for neurodegeneration","volume":"34","author":"Heller","year":"2017","journal-title":"Sleep Med. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/0013-4694(66)90110-6","article-title":"Changes in total amount of stage four sleep as a function of partial sleep deprivation","volume":"20","author":"Dement","year":"1966","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"ref_4","unstructured":"Mindell, J.A., and Owens, J.A. (2015). A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems, Lippincott Williams & Wilkins."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Foulkes, D. (1967). Nonrapid eye movement mentation. Exp. Neurol., 28\u201338.","DOI":"10.1016\/0014-4886(67)90154-9"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"983","DOI":"10.2466\/pms.1964.19.3.983","article-title":"Presleep determinants of dream content: Effects of two films","volume":"19","author":"Foulkes","year":"1964","journal-title":"Percept. Mot. Skills"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1006\/ccog.1994.1004","article-title":"Emotion profiles in the dreams of men and women","volume":"3","author":"Merritt","year":"1994","journal-title":"Conscious. Cogn."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1177\/070674376300800612","article-title":"Reports of mental activity during sleep","volume":"8","author":"Rechtschaffen","year":"1963","journal-title":"Can. Psychiatr. Assoc. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/1467-9280.00306","article-title":"Brain-mind states: Reciprocal variation in thoughts and hallucinations","volume":"12","author":"Fosse","year":"2001","journal-title":"Psychol. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1017\/S0140525X0000399X","article-title":"A review of mentation in REM and NREM sleep:\u201cCovert\u201d REM sleep as a possible reconciliation of two opposing models","volume":"23","author":"Nielsen","year":"2000","journal-title":"Behav. Brain Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1378\/chest.14-0970","article-title":"International classification of sleep disorders","volume":"146","author":"Sateia","year":"2014","journal-title":"Chest"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gackenbach, J., and Sheikh, A.A. (2020). Dream images: A Call To Mental Arms, Routledge.","DOI":"10.4324\/9781315224701"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/01.nmd.0000207359.46223.dc","article-title":"Variety and intensity of emotions in nightmares and bad dreams","volume":"194","author":"Zadra","year":"2006","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.2466\/pms.1987.64.3c.1147","article-title":"Selected sleep disturbances in school children reported by parents: Prevalence, interrelationships, behavioral correlates and parental attributions","volume":"64","author":"Fisher","year":"1987","journal-title":"Percept. Mot. Skills"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0005-7967(99)00155-2","article-title":"Children\u2019s nighttime fears: Parent\u2013child ratings of frequency, content, origins, coping behaviors and severity","volume":"39","author":"Muris","year":"2001","journal-title":"Behav. Res. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1093\/sleep\/31.1.62","article-title":"Longitudinal study of bad dreams in preschool-aged children: Prevalence, demographic correlates, risk and protective factors","volume":"31","author":"Simard","year":"2008","journal-title":"Sleep"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1037\/drm0000034","article-title":"Nightmare prevalence, distress, and anxiety among young children","volume":"26","author":"Floress","year":"2016","journal-title":"Dreaming"},{"key":"ref_18","unstructured":"Kryger, M.H., Roth, T., and Dement, W.C. (2005). Principles and practice of sleep medicine: Dreaming as a mood-regulation system. Principles and Practice of Sleep Medicine, W.B. Saunders. [4th ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1080\/15402002.2015.1017099","article-title":"Things that go bump in the night: Frequency and predictors of nightmares in anxious and nonanxious children","volume":"14","author":"Reynolds","year":"2016","journal-title":"Behav. Sleep Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Meltzer, L.J., and McLaughlin Crabtree, V. (2015). Pediatric Sleep Problems: A Clinician\u2019s Guide to Behavioral Interventions, American Psychological Association.","DOI":"10.1037\/14645-000"},{"key":"ref_21","first-page":"463","article-title":"Gender differences in anxiety dreams of school-aged children","volume":"47","author":"Schredl","year":"1998","journal-title":"Prax. Kinderpsychol. Kinderpsychiatr."},{"key":"ref_22","unstructured":"Moorcroft, W.H., and Belcher, P. (2003). Understanding Sleep and Dreaming, Kluwer Academic\/Plenum Publishers."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1037\/a0036017","article-title":"Evidence for the preferential incorporation of emotional waking-life experiences into dreams","volume":"24","author":"Malinowski","year":"2014","journal-title":"Dreaming"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e12635","DOI":"10.1111\/jsr.12635","article-title":"A review of sleep disturbance in children and adolescents with anxiety","volume":"27","author":"Brown","year":"2018","journal-title":"J. Sleep Res."},{"key":"ref_25","first-page":"534","article-title":"Content analysis of 4 to 8 year-old children\u2019s dream reports","volume":"6","year":"2015","journal-title":"Front. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.smrv.2009.09.003","article-title":"Comorbidity of insomnia and depression","volume":"14","author":"Staner","year":"2010","journal-title":"Sleep Med. Rev."},{"key":"ref_27","unstructured":"American Psychiatric Association (1980). Diagnostic And Statistical Manual of Mental Disorders, American Psychiatric Association."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Fletcher-Watson, S., and Happ\u00e9, F. (2019). Autism: A New Introduction to Psychological Theory and Current Debate, Routledge.","DOI":"10.4324\/9781315101699"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1136\/ebmental-2018-300037","article-title":"Sleep in youth with autism spectrum disorders: Systematic review and meta-analysis of subjective and objective studies","volume":"21","author":"Zhang","year":"2018","journal-title":"Evid. Based Mental Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1007\/s10803-019-03928-y","article-title":"Sleep disturbances increase the impact of working memory deficits on learning problems in adolescents with high-functioning Autism spectrum disorder","volume":"50","author":"Calhoun","year":"2020","journal-title":"J. Autism Dev. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.rasd.2009.04.002","article-title":"Variables related to sleep problems in children with autism","volume":"3","author":"Mayes","year":"2009","journal-title":"Res. Autism Spectr. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3448","DOI":"10.1007\/s10803-016-2884-4","article-title":"Relationship between subtypes of restricted and repetitive behaviors and sleep disturbance in autism spectrum disorder","volume":"46","author":"Hundley","year":"2016","journal-title":"J. Autism Dev. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S83","DOI":"10.1542\/peds.2012-0900F","article-title":"The relationship between sleep problems and daytime behavior in children of different ages with autism spectrum disorders","volume":"130","author":"Sikora","year":"2012","journal-title":"Pediatrics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ridd.2004.05.003","article-title":"Repetitive behaviors in autism: Relationships with associated clinical features","volume":"26","author":"Gabriels","year":"2005","journal-title":"Res. Dev. Disabil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ridd.2003.04.007","article-title":"Sleep problems as possible predictors of intensified symptoms of autism","volume":"25","author":"Schreck","year":"2004","journal-title":"Res. Dev. Disabil."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1016\/j.ridd.2013.01.013","article-title":"Relationship between poor sleep and daytime cognitive performance in young adults with autism","volume":"34","author":"Limoges","year":"2013","journal-title":"Res. Dev. Disabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1037\/drm0000103","article-title":"Nightmares in mental disorders: A review","volume":"29","author":"Lemyre","year":"2019","journal-title":"Dreaming"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.rasd.2011.09.010","article-title":"Sleep problems among Taiwanese children with autism, their siblings and typically developing children","volume":"6","author":"Chou","year":"2012","journal-title":"Res. Autism Spectr. Disord."},{"key":"ref_39","first-page":"e416","article-title":"Validation of the fetal alcohol spectrum disorder (FASD) 4-Digit Diagnostic Code","volume":"20","author":"Astley","year":"2013","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_40","first-page":"4","article-title":"Alcohol and pregnancy: Fetal alcohol spectrum disorders and the fetal alcohol syndrome","volume":"307","author":"Warren","year":"2013","journal-title":"Alcohol Sci. Policy Public Health"},{"key":"ref_41","first-page":"e426","article-title":"A need for closer examination of FASD by the criminal justice system: Has the call been answered?","volume":"18","author":"Gagnier","year":"2011","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/DBP.0b013e3182199694","article-title":"Sleep and sensory characteristics in young children with fetal alcohol spectrum disorder","volume":"32","author":"Wengel","year":"2011","journal-title":"J. Dev. Behav. Pediatrics"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"103610","DOI":"10.1016\/j.ridd.2020.103610","article-title":"Sleep disturbance as a predictor of anxiety in children with Fetal Alcohol Spectrum Disorders and typically developing children","volume":"101","author":"Mughal","year":"2020","journal-title":"Res. Dev. Disabil."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Mughal, R., Hill, C.M., Joyce, A., and Dimitriou, D. (2020). Sleep and cognition in children with fetal alcohol spectrum disorders (FASD) and children with autism spectrum disorders (ASD). Brain Sci., 10.","DOI":"10.3390\/brainsci10110863"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"421","DOI":"10.5664\/jcsm.2038","article-title":"Sleep problems in children with fetal alcohol spectrum disorders","volume":"8","author":"Chen","year":"2012","journal-title":"J. Clin. Sleep Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1093\/sleep\/23.8.1d","article-title":"The Children\u2019s Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children","volume":"23","author":"Owens","year":"2000","journal-title":"Sleep"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3389\/fpsyt.2014.00188","article-title":"Validating the Children\u2019s Sleep Habits Questionnaire against polysomnography and actigraphy in school-aged children","volume":"5","author":"Markovich","year":"2015","journal-title":"Front. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1037\/0021-843X.106.2.280","article-title":"Structure of anxiety symptoms among children: A confirmatory factor-analytic study","volume":"106","author":"Spence","year":"1997","journal-title":"J. Abnorm. Psychol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0005-7916(02)00005-8","article-title":"Reliability and validity of the Spence Children\u2019s Anxiety Scale and the Screen for Child Anxiety Related emotional disorders in German children","volume":"33","author":"Essau","year":"2002","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Roth, R.M., Isquith, P.K., and Gioia, G.A. (2014). Assessment of executive functioning using the Behavior Rating Inventory of Executive Function (BRIEF). Handbook Of Executive Functioning, Springer.","DOI":"10.1007\/978-1-4614-8106-5_18"},{"key":"ref_51","unstructured":"Achenbach, T.M., and Rescorla, L.A. (2003). Manual For The ASEBA Adult Forms & Profiles, Research Center for Children, Youth, & Families, University of Vermont."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.childyouth.2005.09.002","article-title":"Validation of the child behavior checklist for guardians of unaccompanied refugee minors","volume":"28","author":"Bean","year":"2006","journal-title":"Child. Youth Serv. Rev."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Lord, C., and Schopler, E. (1987). Neurobiological implications of sex differences in autism. Neurobiological Issues in Autism, Springer.","DOI":"10.1007\/978-1-4899-1992-2"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/BF02212193","article-title":"Validity and reliability of the Childhood Autism Rating Scale with autistic adolescents","volume":"18","author":"Garfin","year":"1988","journal-title":"J. Autism Dev. Disord."},{"key":"ref_55","first-page":"e440","article-title":"A differential approach for examining the behavioral phenotype of fetal alcohol spectrum disorders","volume":"18","author":"Nash","year":"2011","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_56","unstructured":"Garfield, P. (1984). Your Child\u2019s Dreams, Ballentine."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1037\/1053-0797.16.2.96","article-title":"Video game play and lucid dreams: Implications for the development of consciousness","volume":"16","author":"Gackenbach","year":"2006","journal-title":"Dreaming"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1037\/h0094433","article-title":"A content analysis of bizarre elements in dreams","volume":"5","author":"Revonsuo","year":"1995","journal-title":"Dreaming"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.3389\/fpsyg.2017.01422","article-title":"Understanding the self in individuals with autism spectrum disorders (ASD): A review of literature","volume":"8","author":"Huang","year":"2017","journal-title":"Front. Psychol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Schredl, M. (2017). Theorizing About the Continuity Between Waking and Dreaming: Comment on Domhoff, American Psychological Association.","DOI":"10.1037\/drm0000062"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1037\/h0094339","article-title":"The nightmare: A failure in dream function","volume":"1","author":"Kramer","year":"1991","journal-title":"Dreaming"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1001\/archpediatrics.2010.202","article-title":"Rapid eye movement sleep percentage in children with autism compared with children with developmental delay and typical development","volume":"164","author":"Buckley","year":"2010","journal-title":"Arch. Pediatrics Adolesc. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/aur.1515","article-title":"Utility of the child behavior checklist as a screener for autism spectrum disorder","volume":"9","author":"Havdahl","year":"2016","journal-title":"Autism Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/j.1467-8721.2009.01614.x","article-title":"Nightmares, bad dreams, and emotion dysregulation: A review and new neurocognitive model of dreaming","volume":"18","author":"Levin","year":"2009","journal-title":"Curr. Dir. Psychol. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1177\/000306517001800401","article-title":"A psychophysiological study of nightmares","volume":"18","author":"Fisher","year":"1970","journal-title":"J. Am. Psychoanal. Assoc."},{"key":"ref_66","unstructured":"Lansky, M.R., and Bley, C.R. (1995). Posttraumatic Nightmares: Psychodynamic Explorations, Analytic Press, Inc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s00406-012-0318-7","article-title":"Disturbed dreaming and sleep quality: Altered sleep architecture in subjects with frequent nightmares","volume":"262","author":"Simor","year":"2012","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."}],"container-title":["Clocks &amp; Sleep"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2624-5175\/3\/3\/33\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:00:40Z","timestamp":1760166040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2624-5175\/3\/3\/33"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,16]]},"references-count":67,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["clockssleep3030033"],"URL":"https:\/\/doi.org\/10.3390\/clockssleep3030033","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202108.0079.v1","asserted-by":"object"}]},"ISSN":["2624-5175"],"issn-type":[{"value":"2624-5175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,16]]}}}