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Meltzer LJ, Wainer A, Engstrom E, Pepa L, Mindell JA. Seeing the Whole Elephant: a scoping review of behavioral treatments for pediatric insomnia. Sleep Med Rev 2020; 56:101410. [PMID: 33387973 DOI: 10.1016/j.smrv.2020.101410] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 01/07/2023]
Abstract
Pediatric insomnia is common, impacting up to a third of typically-developing, healthy children, and over 80% of children with neurodevelopmental disorders or chronic medical conditions. Previous reviews of behavioral interventions for pediatric insomnia have had a limited focus on a single age group, a specific population, and/or only randomized controlled trials. Furthermore, few reviews have considered non-sleep outcomes of both children and their parents. This scoping review provides a broader context, including studies regardless of research design or population, along with sleep and non-sleep study outcomes. Clear gaps in the literature were identified, highlighting the need for additional research in different populations, including school-age children and adolescents, racial/ethnic groups around the world, as well as youth with medical or psychiatric disorders. In addition, more research is needed on different features of treatment, including the delivery mode, involvement of all family members, non-sleep outcomes, and long-term follow-up.
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Affiliation(s)
- Lisa J Meltzer
- National Jewish Health, 1400 Jackson Street, G311, Denver, CO 80206, USA.
| | - Allison Wainer
- University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Box F496, Aurora, CO 80045, USA
| | - Erin Engstrom
- University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Box F496, Aurora, CO 80045, USA
| | - Lauren Pepa
- University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Box F496, Aurora, CO 80045, USA
| | - Jodi A Mindell
- Saint Joseph's University, 5600 City Ave, Philadelphia, PA 19131, USA; Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
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Böhmer MN, Oppewal A, Bindels PJE, Tiemeier H, van Someren EJW, Festen DAM. Comparison of sleep-wake rhythms in elderly persons with intellectual disabilities and the general population. Sleep Med 2020; 76:148-154. [PMID: 33186806 DOI: 10.1016/j.sleep.2020.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/30/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sleep problems are common in people with intellectual disabilities (ID), but the knowledge on the natural course of sleep-wake rhythms and sleep problems in elderly persons with ID is limited. In the current study, objectively measured sleep-wake rhythms and the prevalence and severity of sleep problems of elderly persons with ID was compared to that of healthy elderly persons from a large representative sample from the general population. METHODS Actigraphy data of 501 elderly persons with ID (age 62.02 ± 8.02 years, 48% female) from the Healthy Ageing and Intellectual Disabilities study was compared to the data of 1734 elderly persons from the general population (age 62.24 ± 9.34 years, 53% female) from the Rotterdam Study. Main outcome variables were Interdaily stability (IS) and Intradaily variablitiy (IV), total sleep time (TST), Waking after sleep onset (WASO), Short sleep (TST<6 h), Night waking (WASO >90 min). RESULTS Elderly persons with ID had less stable sleep wake rhythms than elderly persons from the general population (IS = 0.70 ± 0.17, vs 0.80 ± 0.10 z = -8.00). Their sleep-wake rhythm was also more fragmented (IV = 0.56 ± 0.26 vs 0.42 ± 0.13 respectively, z = 8.00). Elderly persons with ID slept on average 60.09 min longer than elderly persons from the general population, and lay awake 48.28 min longer after sleep onset. Short sleep in elderly persons with ID was less prevalent (20.7% vs 30.2%) but more severe (TST in Short sleep; 5.13 ± 0.80 h vs 5.39 ± 0.50 h, z = -2.76) then in elderly persons from the general population. Night waking was more prevalent (63.0% vs 17.7%) and more severe in elderly persons with ID (WASO in Night waking; 150.39 ± 54.72 min vs 111.60 ± 17.95 min, z = 7.06). CONCLUSION The differences in sleep-wake rhythms, prevalence and severity of sleep problems between elderly persons with and without ID are marked and possibly explained by medical, psychiatric conditions and lifestyle in elderly persons with ID. Better understanding of sleep in elderly with ID is needed to improve the quality of sleep in this population and to diminish health problems related to a disruption of sleep.
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Affiliation(s)
- Mylène N Böhmer
- Erasmus MC, University Medical Center Rotterdam, Department of General Practice, Intellectual Disability Medicine, the Netherlands; Middin, Care Organization for People with Intellectual Disabilities, Rijswijk, the Netherlands.
| | - Alyt Oppewal
- Erasmus MC, University Medical Center Rotterdam, Department of General Practice, Intellectual Disability Medicine, the Netherlands
| | - Patrick J E Bindels
- Erasmus MC, University Medical Center Rotterdam, Department of General Practice, the Netherlands
| | - Henning Tiemeier
- Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, the Netherlands; Department of Social and Behavioral Sciences, Harvard. T.H. Chan School of Public Health, Boston, MA, USA
| | - Eus J W van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Vrije Universiteit, Department of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Dederieke A M Festen
- Erasmus MC, University Medical Center Rotterdam, Department of General Practice, Intellectual Disability Medicine, the Netherlands; Ipse de Bruggen, Care Organization for People with Intellectual Disabilities, Zoetermeer, the Netherlands
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Carnett A, Hansen S, McLay L, Neely L, Lang R. Quantitative-Analysis of Behavioral Interventions to Treat Sleep Problems in Children with Autism. Dev Neurorehabil 2020; 23:271-284. [PMID: 31355702 DOI: 10.1080/17518423.2019.1646340] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Sleep is an essential activity for human development. Often, children with autism spectrum disorder (ASD) are affected by a lack of sleep due to various types of sleep problems. We identified and analyzed studies that were aimed at utilizing sleep interventions for children with ASD. A systematic search of databases, reference lists, and ancestral searches identified 18 studies for inclusion. Studies were summarized in terms of (a) participants, (b) targeted sleep problem and measures, (d) intervention components, (e) research design and rigor, and (f) results. The aim of this review was to analyze the literature by evaluating the most commonly treated sleep problems, the various treatment components, and strength of the results using a between case parametric effect size estimate. The most commonly treated sleep problems were night wakings and bedtime disturbance. For interventions, all the studies incorporated multiple treatment components, most often including the use of a consistent bedtime routine. Effect size calculations indicated a moderate effect size, however, limited due to the small number of studies. Results suggest the overall effectiveness of behavioral interventions for the treatment of sleep problems for children with ASD. Based on our analysis, suggestions for practitioners regarding current practices and future directions for research are discussed.
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Affiliation(s)
- Amarie Carnett
- San Antonio Applied Behavior Analysis Research Consortium, University of Texas at San Antonio , San Antonio, TX, USA
| | | | - Laurie McLay
- University of Canterbury , Christchurch, New Zealand
| | - Leslie Neely
- San Antonio Applied Behavior Analysis Research Consortium, University of Texas San Antonio , San Antonio, TX, USA
| | - Russell Lang
- Clinic for Autism Research Evaluation and Support, Texas State University , San Marcos, TX, USA
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Pereira L, Sampson J, DiCola K. Factors Related to Linguistic Content in Video Narrative of Adolescents with Cancer and Healthy Controls. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2019; 48:1185-1201. [PMID: 31222472 DOI: 10.1007/s10936-019-09652-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A long history exists of the utilization of narratives to help young people cope with stress and illness. Research is beginning to focus on video based story-telling for the purpose of intervention, however little research has been conducted to look at factors that influence the narrative content of these films. As a pilot, and within the context of a larger study, the current research was conducted with n = 10 adolescents with cancer and n = 10 healthy peers exploring participant characteristics (e.g. personality, quality of life, etc.) and their relationship with linguistic consent of the film. Despite little to no differences identified in demographic characteristics, results identified distinct differences between each group, suggesting that linguistic aspects of film narratives differ in adolescents with and without cancer. This research can serve to motivate future directions of exploration surrounding the content of film narratives and their relationship to patient well-being.
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Shanahan PJ, Palod S, Smith KJ, Fife‐Schaw C, Mirza N. Interventions for sleep difficulties in adults with an intellectual disability: a systematic review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:372-385. [PMID: 30628125 PMCID: PMC6850627 DOI: 10.1111/jir.12587] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 12/04/2018] [Accepted: 12/12/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND Current literature highlights higher prevalence rates of sleep difficulties amongst adults with an intellectual disability. However, no synthesis has been conducted to assess the effectiveness of existing interventions in this population. Thus, the aim of this review was to assess the effectiveness of sleep interventions in adults with an intellectual disability (ID). METHOD Eight databases were searched to identify interventions for sleep difficulties amongst adults with an ID. The study quality was assessed with the Risk Of Bias In Non-randomised Studies - of Interventions. Nine studies (n = 97) were eligible for inclusion in the review. RESULTS There was a notable study on heterogeneity in terms of the population, study design, intervention studied, sleep assessment and outcome assessments used. Eight of the nine studies reported improvement in sleep following intervention. However, these findings need additional support as only 97 participants involving a variety of interventions and measurement systems were used across all studies. Furthermore, eight of the nine studies had serious to critical risk of bias. The only study identified as having low risk of bias was a placebo-controlled randomised controlled trial for the use of melatonin. CONCLUSIONS This review highlights the need for objective measures such as actigraphy and studies with greater experimental control investigating sleep interventions in adults with ID.
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Affiliation(s)
- P. J. Shanahan
- Department of Psychological Sciences, School of Psychology, Faculty of Health and MedicineUniversity of SurreyGuildfordUK
- Neurodevelopmental ServicesYour Healthcare CICSurbitonUK
| | - S. Palod
- Neurodevelopmental ServicesYour Healthcare CICSurbitonUK
| | - K. J. Smith
- Department of Psychological Sciences, School of Psychology, Faculty of Health and MedicineUniversity of SurreyGuildfordUK
| | - C. Fife‐Schaw
- Department of Psychological Sciences, School of Psychology, Faculty of Health and MedicineUniversity of SurreyGuildfordUK
| | - N. Mirza
- Sutton and Merton Mental Health Intellectual Disability TeamJubilee Health CentreWallingtonUK
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Boban S, Wong K, Epstein A, Anderson B, Murphy N, Downs J, Leonard H. Determinants of sleep disturbances in Rett syndrome: Novel findings in relation to genotype. Am J Med Genet A 2016; 170:2292-300. [PMID: 27255190 DOI: 10.1002/ajmg.a.37784] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/11/2016] [Indexed: 11/11/2022]
Abstract
Rett syndrome is a rare but severe neurological disorder associated with a mutation in the methyl CpG binding protein 2 (MECP2) gene. Sleep problems and epilepsy are two of many comorbidities associated with this disorder. This study investigated the prevalence and determinants of sleep problems in Rett syndrome using an international sample. Families with a child with a confirmed Rett syndrome diagnosis and a MECP2 mutation registered in the International Rett Syndrome Phenotype Database (InterRett) were invited to participate. Questionnaires were returned by 364/461 (78.9%) either in web-based or paper format. Families completed the Sleep Disturbance Scale for Children and provided information on the presence, nature, and frequency of their child's sleep problems. Multivariate multinomial regression was used to investigate the relationships between selected sleep problems, age group, and genotype and linear regression for the relationships between sleep disturbance scales and a range of covariates. Night waking was the most prevalent sleep problem affecting over 80% with nearly half (48.3%) currently waking often at night. Initiating and maintaining sleep was most disturbed for younger children and those with a p.Arg294* mutation. Severe seizure activity was associated with poor sleep after adjusting for age group, mutation type, and mobility. We were surprised to find associations between the p.Arg294* mutation and some sleep disturbances given that other aspects of its phenotype are milder. These findings highlight the complexities of aberrant MECP2 function in Rett syndrome and explain some of the variation in manifestation of sleep disturbances. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sharolin Boban
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Kingsley Wong
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Amy Epstein
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Barbara Anderson
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Nada Murphy
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
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Spruyt K, Curfs LMG. Non-pharmacological management of problematic sleeping in children with developmental disabilities. Dev Med Child Neurol 2015; 57:120-36. [PMID: 25370592 DOI: 10.1111/dmcn.12623] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2014] [Indexed: 12/23/2022]
Abstract
AIM Sleep is important for underlying neural plasticity, and children with developmental disabilities suffer behavioural, emotional, cognitive, and sensory-motor issues that affect their wake and sleep states. Problematic sleeping can be hypothesized to have adverse effects on both of these areas in children with developmental disabilities. With this review, we aim to provide a benchmark in managing problematic sleeping in children with developmental disabilities. METHOD A literature search was conducted and data on the study descriptives, patient characteristics, study design, study-related factors, criteria applied to operationalize sleep and developmental disability, and sleep 'management' were collected. Each management strategy was tabulated and analysed. RESULTS We identified 90 studies involving 1460 children with developmental disabilities, of whom 61.6% were male. The highest proportion of studies, almost half, were in children with syndromes (44.4%), followed by studies in children with intellectual disabilities (18.9%). Non-pharmacological sleep management was primarily aimed at improving sleep quality (86.7%), followed by sleep-wake schedules and, to a certain extent, sleep regularity (42.2%). About 56.7% of the studies reported more than one approach. Studies mostly focused on disorders of initiating and maintaining sleep through a diversity of strategies and relied heavily on subjective measures to identify and monitor problematic sleeping. Sleep management approaches were primarily delivered at the level of the individual in the home setting. The number of management approaches per study was unrelated to the number of sleep problems discussed. INTERPRETATION Modifying sleep management strategies to meet the specific needs of children with developmental disabilities is encouraged, and studies that look beyond sleep quality or sleep quantity are required. It is also advocated that modifications to sleep hygiene, sleep regularity, and sleep ecology in a population with developmental disabilities are rigorously investigated. Finally, daytime somnolence should not be overlooked when aiming to optimize sleep in children with developmental disabilities across the ages and stages of their lives. There were several limitations in the research findings of problematic sleep in children with developmental disabilities. In general, the sleep problems and the developmental disabilities investigated were multicomponent in nature. It is likely that management approaches impacted those problems on multiple levels or through diverse 'therapeutic' pathways. There is a need for randomized controlled trials and more objective measures that quantify improved sleep or wake states.
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Affiliation(s)
- Karen Spruyt
- Maastricht University Medical Centre, Rett Expertise Centre-Governor Kremers Centre, Maastricht, the Netherlands; Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai, China
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Wong K, Leonard H, Jacoby P, Ellaway C, Downs J. The trajectories of sleep disturbances in Rett syndrome. J Sleep Res 2014; 24:223-33. [PMID: 25219940 DOI: 10.1111/jsr.12240] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 08/03/2014] [Indexed: 11/27/2022]
Abstract
Rett syndrome is a rare neurodevelopmental disorder usually affecting females, and is associated with a mutation in the MECP2 gene. Sleep problems occur commonly and we investigated the trajectories and influences of age, mutation and treatments. Data were collected at six time points over 12 years from 320 families registered with the Australian Rett Syndrome Database. Regression analysis was used to investigate relationships between sleep disturbances, age, mutation type and use of treatment, and latent class growth analysis was performed to identify sleep problem phenotypes and model the effect of mutation type. The age range of subjects was 2.0-35.8 years. The study showed that sleep problems occurred in more than 80% of individuals and the prevalence decreased with age. Night laughing and night screaming occurred in 77 and 49%, respectively, when younger. Those with a large deletion had a higher prevalence of night laughing, which often occurred frequently. Treatment was associated with a 1.7% reduction in risk of further sleep problems. High and low baseline prevalence groups were identified. Approximately three-quarters of girls and women with sleep disturbances were in the high baseline group and problems persisted into adulthood. Conversely, 57% with night laughing and 42% with night screaming in the high baseline group exhibited mild improvement over time. Mutation type was not found to be a significant predictor of group membership. In conclusion, the evolution of sleep problems differed between subgroups of girls and women with Rett syndrome, in part explained by age and genotype. Treatment was not associated with improvement in sleep problems.
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Affiliation(s)
- Kingsley Wong
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, West Perth, WA, Australia
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Abstract
Abstract
Developmental disorders in children are common. Associated demanding co-morbidities that include sleep problems are prevalent in this group. In turn, these are linked to daytime performance issues, reduced developmental and academic growth, and considerable familial psychopathology. Behavioral modification measures are and should be the first line approach to management. Medications for sleep disorders have an important role in addition to behavioral modification therapy. This literature review looks into the occurrence and severity of sleep problems in children with developmental disorders. The probable advantages of using medications, mainly focusing on the neurohormone melatonin (a sleep inducer), are also explored.
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Affiliation(s)
- Oneza Ahmareen
- Midland Regional Hospital-Pediatrics, Mullingar, Westmeath, Ireland
| | - Elaine Neary
- Midland Regional Hospital-Pediatrics, Mullingar, Westmeath, Ireland
| | - Farhana Sharif
- Midland Regional Hospital-Pediatrics, Mullingar, Westmeath, Ireland
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Didden R, de Moor JMH, Curfs LMG. Behavioural Treatment of Sleep Problems in Three Children with Developmental Disabilities. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/096979504799103976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Brown CA, Kuo M, Phillips L, Berry R, Tan M. Non-pharmacological sleep interventions for youth with chronic health conditions: A critical review of the methodological quality of the evidence. Disabil Rehabil 2012; 35:1221-55. [DOI: 10.3109/09638288.2012.723788] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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van de Wouw E, Evenhuis HM, Echteld MA. Prevalence, associated factors and treatment of sleep problems in adults with intellectual disability: a systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1310-1332. [PMID: 22502859 DOI: 10.1016/j.ridd.2012.03.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 03/02/2012] [Accepted: 03/02/2012] [Indexed: 05/31/2023]
Abstract
In people with intellectual disability (ID), impaired sleep is common. Life expectancy has increased in this group, and it is known that in general population sleep deteriorates with aging. Therefore the aims of this systematic review were to examine how sleep problems are defined in research among adults and older people with ID, and to collect information on the prevalence, associated factors and treatment of sleep problems in this population. PubMed, EMBase, PsycINFO and Web of Science were searched for studies published between January 1990 and August 2011. All empirical studies covering sleep problems in adults with ID were included, and assessed on quality (level of evidence), using a slightly modified version of the SIGN-50 methodology checklist for cohort studies. Of 50 studies that were included for systematic review, one was of high quality, 14 were well conducted, 14 were well conducted but with a high risk of bias, and 21 were non-analytical. The reported estimated prevalence rates of sleep problems in adults with ID ranged from 8.5% to 34.1%. A prevalence of 9.2% was reported for significant sleep problems. Sleep problems were associated with the following factors: challenging behavior; respiratory disease; visual impairment; psychiatric conditions; and using psychotropic, antiepileptic and/or antidepressant medication. Little information was found on older people specifically. Two studies reported treatment effects on sleep problems in larger populations; their findings suggest that non-pharmaceutical interventions are beneficial. Research on the prevalence, associated factors and treatment of sleep problems in adults and older people with ID has mainly focused on subjectively derived data. The definitions used to describe a sleep problem are not uniform, and associations are mainly described as correlations. In order to give recommendations for clinical practice further research is needed, involving objective measurements and multivariate analysis.
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Affiliation(s)
- E van de Wouw
- Erasmus Medical Center, Department of General Practice, Intellectual Disability Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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Maladaptive behaviors are linked with inefficient sleep in individuals with developmental disabilities. J Neurodev Disord 2010; 2:174-180. [PMID: 20700513 PMCID: PMC2914862 DOI: 10.1007/s11689-010-9048-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 04/23/2010] [Indexed: 11/30/2022] Open
Abstract
The purpose of the current study was to assess the relations between nightly sleep patterns and the frequency of daily maladaptive behavior. Antecedent and consequential relations between sleep patterns and behavior were evaluated with time series analysis. Sleep efficiency and maladaptive behavior were determined for 20 female residents of an institutional care facility for adults with developmental disabilities. Daily maladaptive behavioral data and nightly sleep/awake logs were collected for 4 months for each participant. Efficient sleep patterns were significantly associated with lower frequencies of maladaptive behaviors. All lagged cross-correlations 8 days before and 8 days after an evening of sleep were significant. These findings suggested that inefficient sleep was associated with increased maladaptive behaviors and that the lagged associations reflected a chronic but not an acute linkage between sleep and behavior.
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Maas APHM, Didden R, Korzilius H, Braam W, Smits MG, Curfs LMG. Sleep in individuals with Cri du Chat syndrome: a comparative study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2009; 53:704-715. [PMID: 19508289 DOI: 10.1111/j.1365-2788.2009.01184.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Sleep problems are common in individuals with intellectual disability. Little is known about sleep in children and adults with Cri du Chat syndrome (CDC). METHOD Sleep was investigated in 30 individuals with CDC using a sleep questionnaire. Sleep problems and sleep behaviours in individuals with CDC were compared with individuals with non-specific intellectual disabilities (NS) (n = 30) and Down's syndrome (DS) (n = 30). RESULTS Nine individuals with CDC (i.e. 30%) had a sleep problem, compared with seven individuals with NS (i.e. 23%) and three individuals with DS (i.e. 10%). Though there were few differences between diagnostic groups, night waking problems were most common in CDC. Individuals with CDC frequently showed behaviours related to disordered breathing and poor-quality sleep. Several behaviours related to sleep had a higher occurrence in CDC than in DS (P < 0.05) but not in NS. CONCLUSIONS It is concluded that individuals with CDC do not have an increased probability of sleep problems as compared with other individuals who share similar demographic characteristics. Hypotheses about causes of night waking problems in CDC are generated and suggestions for future research of sleep in individuals with CDC are given.
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Affiliation(s)
- A P H M Maas
- GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, the Netherlands.
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O’Connell A, Vannan K. Sleepwise: Addressing sleep disturbance in young children with developmental delay. Aust Occup Ther J 2008; 55:212-4. [DOI: 10.1111/j.1440-1630.2007.00717.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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DeVincent CJ, Gadow KD, Delosh D, Geller L. Sleep disturbance and its relation to DSM-IV psychiatric symptoms in preschool-age children with pervasive developmental disorder and community controls. J Child Neurol 2007; 22:161-9. [PMID: 17621477 DOI: 10.1177/0883073807300310] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study describes the relation between sleep problems and psychiatric symptoms in preschool-age children (3 to 5 years old) with pervasive developmental disorder and a community-based sample of children attending early childhood programs. Parents completed the Early Childhood Inventory-4, a Diagnostic and Statistical Manual of Mental Disorders (fourth edition)-referenced rating scale for 2 samples: children with pervasive developmental disorder (n = 112) and nondisabled youngsters (n = 497). Although children with pervasive developmental disorder had a significantly greater number and severity of sleep problems than the community preschoolers did, sleep-disturbed children in both samples exhibited more severe behavioral difficulties-primarily symptoms of attention-deficit hyperactivity disorder and oppositional defiant disorder-than did children without sleep problems. Sleep problems are an indicator of similar comorbid psychiatric symptoms in both children with and without pervasive developmental disorder, which suggests commonalities in their etiology.
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Affiliation(s)
- Carla J DeVincent
- Cody Center for Autism and Developmental Disabilities, Department of Pediatrics, State University of New York at Stony Brook 11794-8788, USA.
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Doran SM, Harvey MT, Horner RH. Sleep and Developmental Disabilities: Assessment, Treatment, and Outcome Measures. ACTA ACUST UNITED AC 2006; 44:13-27. [PMID: 16405384 DOI: 10.1352/0047-6765(2006)44[13:saddat]2.0.co;2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
People with developmental disabilities sleep less and experience higher incidence of clinical sleep disorders than the general population. Exploring the neurophysiology linking sleep with daytime performance in patients with developmental disabilities is now possible using minimally sufficient sleep and sleep-sensitive behavioral assays. Although frequent sampling represents the primary difficulty, it is required to untangle coincident effects of sleep quality amidst circadian variation. Recent evidence finds high quality sleep promotes brain plasticity, improves health measures, and enriches quality of life. Sleep treatments for apnea, insomnia, restless limbs, and conditioned sleep-aversion are available, although not readily provided, for people with developmental disabilities. This population would gain both clinical and behavioral benefits as improved sleep-monitoring, behavioral testing, and sleep-treatment technology is adapted to their needs.
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Affiliation(s)
- Scott M Doran
- Department of Special Education, Box 40, Vanderbilt University, Nashville, TN 37203, USA.
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Affiliation(s)
- Judith A Owens
- Department of Pediatrics, Brown University Medical School, Providence, Rhode Island, USA
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