Children with autism and sleep disorder exhibit impaired neuroclearance linked to systemic iron deficiency
In a study of 230 children with ASD (114 with sleep disorder, ASD-SD; 116 without, ASD-nSD) and 110 typically developing controls, ASD-SD children showed significantly reduced ALPS indices and elevated free water fraction, indicating impaired perivascular clearance. Serum iron was markedly lower in ASD-SD, and mediation analysis supported a pathway from iron deficiency to cerebral edema to impaired neuroclearance.
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Children with autism and sleep disorder exhibit impaired neuroclearance linked to systemic iron deficiency The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Children with autism and sleep disorder exhibit impaired neuroclearance linked to systemic iron deficiency
This conclusion is most relevant to: Children with autism spectrum disorder (ASD) aged 2-17 years, with and without comorbid sleep disorder, plus typically developing controls.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Neuroclearance dysfunction in autism with sleep disorder: MRI evidence and mediation by systemic iron deficiency. (Journal of affective disorders, 2026) —
How It Works
The proposed biological pathway:
- ▸Systemic iron deficiency
- ▸Increased cerebral edema (elevated free water fraction)
- ▸Impaired perivascular neuroclearance (reduced ALPS index)
- ▸Sleep disruption exacerbates neurodevelopmental impairments
Who Might Benefit
Evidence fit by population:
- ▸Children with autism spectrum disorder (ASD) aged 2-17 years, with and without comorbid sleep disorder, plus typically developing controls
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Cross-sectional design prevents causal inference
- ▸Single-center study may limit generalizability
- ▸Sleep disorder diagnosis based on clinical criteria, not objective polysomnography
Frequently Asked Questions
What is the ALPS index?▼
The ALPS index (diffusion kurtosis imaging along the perivascular space) is an MRI measure of perivascular clearance function, reflecting the brain's ability to clear waste products via the glymphatic system.
How does iron deficiency relate to sleep in autism?▼
The study found that children with ASD and sleep disorder had significantly lower serum iron levels, and mediation analysis suggested iron deficiency contributes to impaired neuroclearance by increasing cerebral edema.
Can iron supplementation help sleep in autistic children?▼
The authors suggest that iron supplementation combined with sleep optimization may be a targeted intervention, but the study does not test this directly; further clinical trials are needed.
What was the sample size and composition?▼
The study included 230 children with ASD (114 with sleep disorder, 116 without) and 110 typically developing controls, totaling 340 participants.
References
- 1.Yin BY, Deng YY, Chen X, Zhao JY, Ni YX, Zhong SS, Zou FY, Shen LS, Luo XW, Zhou X, Zhang JL, Zhou WY, Deng HZ, Guo RM. “Neuroclearance dysfunction in autism with sleep disorder: MRI evidence and mediation by systemic iron deficiency..” Journal of affective disorders, 2026. PMID: 42208817 DOI: 10.1016/j.jad.2026.122035