Sleep Disturbance and Aggressive Behaviour among Children with Autism Spectrum Disorder: The Moderating Role of Emotion Regulation

Purpose: This study examines the relationship between sleep disturbance and aggressive behaviour among children with Autism Spectrum Disorder (ASD) in Pakistan, focusing on the moderating role of emotion regulation. Methodology: A quantitative cross-sectional correlational design was employed using purposive sampling to recruit 260 children with ASD through their caregivers from autism centers, rehabilitation clinics, and special education institutions in Pakistan. Standardized instruments were used, including the Children’s Sleep Habits Questionnaire (CSHQ), the Institute for Basic Research–Modified Overt Aggression Scale (IBR-MOAS), and the Emotion Regulation Checklist (ERC). Data were analyzed using SPSS Version 27 and Hayes’ PROCESS Macro Version 4.2 (Model 1). Pearson correlation analysis and moderation analysis were conducted to examine the hypothesized relationships among study variables. Findings: Results revealed that sleep disturbance was significantly and positively associated with aggressive behaviour, while sleep disturbance was significantly and negatively associated with emotion regulation. Emotion regulation also demonstrated a significant negative relationship with aggressive behaviour. Moderation analysis indicated that emotion regulation significantly weakened the positive relationship between sleep disturbance and aggressive behaviour. Specifically, the association between sleep disturbance and aggression was stronger among children with lower levels of emotion regulation and weaker among those with higher levels of emotion regulation, supporting the buffering role of emotion regulation. Unique Contribution to Theory, Policy, and Practice: This study extends Gross's Process Model of Emotion Regulation (1998) by demonstrating that Emotion regulation buffers the association between sleep disturbances and aggressive behaviour among children with Autism Spectrum Disorder (ASD). The findings underscore the importance of integrating emotion regulation training with sleep management interventions in clinical, educational, and family settings. These results support the development of policies and interventions aimed at enhancing emotion regulation and psychological well-being among children with ASD in Pakistan.