web stats
Selected Development Project
Project Title

Eamining the association between physical activity and sleep quality in children with Autism Spectrum Disorder using melatonin-mediated mechanism model: A randomized controlled trial

Principal Investigator Dr Tse Choi-yeung
Area of Research Project
Psychological Studies
Project Period
From 1/1/2018 To 30/6/2020
  • To examine the association between physical activity and sleep quality in childrenwith ASD.
  • To examine the possible sustained effects of physical activity on improving melatonin secretion and sleep quality in children with ASD.
  • To investigate how physical activity impacts sleep via the melatonin-mediated mechanism model.
    Methods Used
    In this study, we have conducted a randomized controlled trial of 32 child participants with ASD that compares a jogging intervention group and a control group. We have monitored the changes of their sleep quality as depicted by four sleep parameters (sleep onset latency, sleep efficiency, wake after sleep onset and sleep duration) through objective actigraphic assessment and parental sleep logs. To measure melatonin level, all participants were instructed to collect a 24-h urine sample. 6-sulfatoxymelatonin, a creatinine-adjusted morning urinary melatonin representative of the participant’s melatonin levels, were measured from the sample. All assessments were carried out before the intervention (T1), immediately after the 12 weeks of physical activity or regular treatment (T2), and 12 weeks post-intervention (T3) to examine the sustainability of the intervention effects.
    Summary of Findings
    1. Baseline and post 12-week exercise intervention urinary 6-sulphatoxymelatonin means (ng/ml)
    2.   Baseline Post-intervention
      urinary 6-sulphatoxymelatonin means (ng/ml) Exercise group Control group p Exercise group Control group p
      4.65±5.27 3.31±4.87 0.26 8.09±5.24 4.09±3.38 0.03

    3. Exercise intervention increased the overall melatonin level in children with ASD.

    This proposed study is the first randomized control trial to investigate the effectiveness of physical activity intervention on sleep disorder among children with ASD. In addition, it is also the first step of studying the melatonin-mediated mechanism of the possible underlying causal pathways by which physical activity impacts on sleep in children with ASD. The results obtained in this study have two significant impacts. First, if the intervention is effective, doctors can then prescribe physical activity to children with ASD who are not able to take drugs based on the concept of ‘exercise is medicine’. Second, the melatonin-mediated mechanism investigated in this study could lead to further investigation of the interactions between physical activity and melatonin in any population suffering from sleep disturbance. Such research could include comparison of the effectiveness of physical activity and supplemental melatonin interventions on sleep quality in populations suffering from sleep disorders and the manipulation of different physical activity intervention parameters (e.g., intensity, frequency, and time) on melatonin level and sleep quality.

    Selected Output
    1. Tse ACY, Lee PH, Zhang J, Lai EWH. Study protocol for a randomised controlled trial examining the association between physical activity and sleep quality in children with autism spectrum disorder based on the melatonin-mediated mechanism model. BMJ Open. 2018 Apr 13;8(4): e020944.

    2. Tse ACY, Lee HP, Chan KSK, Edgar VB, Wilkinson-Smith A, Lai WHE. Examining the impact of physical activity on sleep quality and executive functions in children with autism spectrum disorder: A randomized controlled trial. Autism. 2019 Oct;23(7):1699-1710.
    Biography of Principal Investigator

    Dr Andy Tse Choi-yeung is and Assistant Professor of Department of Health and Physical Education. Dr Tse obtained his BSc (Sports Science) and PhD (Speech Motor Learning) from the University of Hong Kong in 2008 and 2012 respectively. Dr Tse’s primary research interest lies on the motor learning and impact of physical activity on psychological, cognitive and physical well-being in children with autism spectrum disorder. He is also interested in motor development and the effect of free-play on overall quality of life in typically developing children. He recently initiates a new research project on the investigation of free-play participation among school-aged children. His research goal is to propose a lighthouse parenting strategy as a reasonable approach to build success among children.

    Funding Source

    Early Career Scheme