Cardiovascular disease risk factors in autistic adults: The impact of sleep quality and antipsychotic medication use

Autism Res. 2023 Mar;16(3):569-579. doi: 10.1002/aur.2872. Epub 2022 Dec 9.


Approximately 40% of American adults are affected by cardiovascular disease (CVD) risk factors (e.g., high blood pressure, high cholesterol, diabetes, and overweight or obesity), and risk among autistic adults may be even higher. Mechanisms underlying the high prevalence of CVD risk factors in autistic people may include known correlates of CVD risk factors in other groups, including high levels of perceived stress, poor sleep quality, and antipsychotic medication use. A sample of 545 autistic adults without intellectual disability aged 18+ were recruited through the Simons Foundation Powering Autism Research, Research Match. Multiple linear regression models examined the association between key independent variables (self-reported perceived stress, sleep quality, and antipsychotic medication use) and CVD risk factors, controlling for demographic variables (age, sex assigned at birth, race, low-income status, autistic traits). Overall, 73.2% of autistic adults in our sample had an overweight/obesity classification, 45.3% had high cholesterol, 39.4% had high blood pressure, and 10.3% had diabetes. Older age, male sex assigned at birth, and poorer sleep quality were associated with a higher number of CVD risk factors. Using antipsychotic medications was associated with an increased likelihood of having diabetes. Poorer sleep quality was associated with an increased likelihood of having an overweight/obesity classification. Self-reported CVD risk factors are highly prevalent among autistic adults. Both improving sleep quality and closely monitoring CVD risk factors among autistic adults who use antipsychotic medications have the potential to reduce risk for CVD.

Keywords: antipsychotic medications; cardiovascular disease; health; sex differences; sleep quality.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents* / adverse effects
  • Autism Spectrum Disorder* / drug therapy
  • Autistic Disorder* / chemically induced
  • Autistic Disorder* / epidemiology
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / drug therapy
  • Cardiovascular Diseases* / epidemiology
  • Cholesterol
  • Diabetes Mellitus* / epidemiology
  • Humans
  • Hypertension*
  • Infant, Newborn
  • Male
  • Obesity / complications
  • Obesity / epidemiology
  • Overweight
  • Risk Factors
  • Sleep Quality
  • United States


  • Antipsychotic Agents
  • Cholesterol