The relationship between sleep, interoception, and autistic traits – what role does thermoregulation play?

Autistic individuals often experience differences in interoception, including difficulties perceiving or interpreting bodily signals (Shah et al., 2016), and commonly report sleep disturbances (Pavlopoulou, 2020). Thermoregulation, which depends on interoceptive feedback, plays a key role in sleep onset and maintenance (Harding et al., 2020). Although interoception is closely linked to sleep regulation (Wei & Van Someren, 2020), no research has directly examined the relationship between sleep, interoception, and thermoregulation in autism. This study investigated whether interoceptive abilities, thermoregulation, and autistic traits predict sleep difficulties in adults. A general population sample (N = 234) completed an online survey assessing global sleep difficulty (GSD) (measure: PSQI), alongside measures of interoceptive attention (IAT), interoceptive accuracy (IAS), temperature sensitivity (STRAQ-1), trait anxiety (GAD-7), and autistic traits (AQ-28). FDR-corrected correlations showed that GSD was positively associated with trait anxiety (r = .436, p < .001), interoceptive attention (r = .195, p = .019), and high temperature sensitivity (r = .227, p = .022), and negatively associated with interoceptive accuracy (r = –.178, p = .028). Hierarchical regression for GSD showed that trait anxiety (β = .46, p < .001) and age (β = .24, p < .001) were the only significant predictors, explaining 27% of the variance in GSD (F(9, 224) = 9.39, R² = .27, p < .001). A separate regression model predicting sleep latency (SOL) found that trait anxiety was the only significant predictor, though the model explained a modest amount of variance (F(1, 232) ≈ 3.66, R² = .031, p = .027). These findings underscore the central role of anxiety in sleep disturbance and support further research into interoceptive profiles in autistic and sensory-sensitive individuals. Interventions targeting anxiety and interoception may offer novel pathways for improving sleep in neurodivergent populations.