Background: Sleep disturbances in children with autism spectrum disorder (ASD) are a significant concern, impacting their development and quality of life. Understanding these disturbances in diverse cultural contexts is essential for effective management and intervention. Objective: This study aimed to investigate the frequency and factors associated with sleep irregularities in children with ASD attending special education departments in Lahore, Pakistan. Methodology: A cross-sectional approach was employed, involving children diagnosed with ASD. Data on sleep disturbances, demographic details, family dynamics, parental education, and occupation were gathered through structured questionnaires. Statistical analyses, including Pearson Chi-Square was performed by using software package for social sciences 26.0 to identify significant associations. Results: In a study of 110 ASD children, 68.2% were male, with 66.3% diagnosed at 3-4 years. Treatment breakdown: 47.3% under-treatment, 33.6% not treated. Fathers were primary caretakers in 42.7% of cases. Socioeconomic status: 82.7% middle class. Sleep disturbances showed 33.7% severe sleep disorders in females and 66.3% severe issues in males. No significant gender difference in sleep disturbances was noted. Treatment type was significantly linked to sleep disturbance severity (p 0.015). A comorbidity, ADHD, was strongly associated with sleep disorders (p < 0.05). No significant associations were observed between electronic devices, gadget use duration, co-sleeping arrangements, and sleep disorders (p < 0.05). The SDSC revealed significant differences in sleep disturbances, particularly in sleep-wake transition and excessive somnolence disorders, across autism severities (p < 0.05). Conclusion: The study highlights the multifaceted nature of sleep disturbances in children with ASD, influenced by gender, autism severity, treatment type, and parental factors. These findings emphasize the need for comprehensive, context-specific approaches in managing and understanding sleep disorders in ASD.