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Böhmer MN, Oppewal A, Bindels PJE, van Someren EJW, Festen DAM. Long-term effects of environmental dynamic lighting on sleep-wake rhythm, mood and behaviour in older adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:620-638. [PMID: 38504557 DOI: 10.1111/jir.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Sleep-wake problems and depressive symptoms are common in people with intellectual disabilities (IDs) and are thought to be related to the unstable sleep-wake rhythm in this population. Previously, we showed that after increasing environmental light exposure, mid-sleep and sleep onset advanced, and mood improved over a period of 14 weeks after installing environmental dynamic light installations in the living room of people with IDs. We invited participants of that short-term study to take part in the current study on sleep-wake rhythm, mood and behaviour in older adults with IDs 1 year after installing environmental dynamic light installations in the common living rooms of six group homes. METHODS A pre-post study was performed from October 2017 to February 2019. We included 45 participants (63.5 ± 8.5 years, 67% female) from six group home facilities who provided data at baseline (9, 4 and 1 weeks prior to installing light installations), short term (3, 7 and 14 weeks after installing light installations) and 1 year (54 weeks after installing light installations). Wrist activity was measured with actigraphy (GENEActiv) to derive the primary outcome of interdaily stability of sleep-wake rhythms as well as sleep estimates. Mood was measured with the Anxiety, Depression and Mood Scale. Behaviour was measured with the Aberrant Behaviour Checklist. RESULTS One year after installing dynamic lighting, we did not find a change in interdaily stability. Total sleep time decreased (β = -25.40 min; confidence interval: -10.99, -39.82), and sleep onset time was delayed (β = 25.63 min; confidence interval: 11.18, 40.08). No effect on mood or behaviour was found. CONCLUSIONS We did not find a change in sleep-wake rhythm, mood or behaviour in older persons with IDs living in care facilities 1 year after installing the light. We did find evidence for a long-term effect on sleep duration and sleep timing. The results have to be interpreted with care as the current study had a limited number of participants. The need for more research on the long-term effects of enhancing environmental light in ID settings is evident.
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Affiliation(s)
- M N Böhmer
- Department of General Practice, Intellectual Disability Medicine Research, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Middin, Care Organization for People with Intellectual Disabilities, Rijswijk, The Netherlands
| | - A Oppewal
- Department of General Practice, Intellectual Disability Medicine Research, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - P J E Bindels
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - E 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
- Department of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Amsterdam, The Netherlands
| | - D A M Festen
- Department of General Practice, Intellectual Disability Medicine Research, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Ipse de Bruggen, Care Organization for People with Intellectual Disabilities, Zoetermeer, The Netherlands
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Harper L, McAnelly S, Walshe I, Ooms A, Tuffrey-Wijne IM. Behavioural sleep problems in children and adults with intellectual disabilities: An integrative literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:916-928. [PMID: 37177858 DOI: 10.1111/jar.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being. METHODS An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015. RESULTS Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability. CONCLUSION A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.
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Affiliation(s)
- Lynette Harper
- Health and Life Sciences, Northumbria University, London, UK
| | - Su McAnelly
- Health and Life Sciences, Northumbria University, London, UK
| | - Ian Walshe
- Health and Life Sciences, Northumbria University, London, UK
| | - Ann Ooms
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
| | - Irene M Tuffrey-Wijne
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
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Böhmer MN, Oppewal A, Valstar MJ, Bindels PJE, van Someren EJW, Maes‐Festen DAM. Light up: an intervention study of the effect of environmental dynamic lighting on sleep-wake rhythm, mood and behaviour in older adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:756-781. [PMID: 36004439 PMCID: PMC9541498 DOI: 10.1111/jir.12969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence-based interventions to improve the sleep-wake rhythm, mood and behaviour in older adults with intellectual disabilities (ID) are limited. Increasing light exposure has been shown to be effective in improving the sleep-wake rhythm, mood, and behaviour in other populations. The current study investigates the effect of installing environmental dynamic lighting in common living rooms of care facilities on sleep-wake rhythm, mood, and behaviour in older adults with ID. METHODS A non-randomised, non-concurrent, multiple baseline study was performed from October 2017 to May 2018. Fifty-four participants [mean (SD) age of 63.42 (8.6) years, 65% female] in six care facilities were included. All participants had three baseline measurements (Weeks 1, 5 and 9). Dynamic lighting was installed in Week 10, after which three intervention measurements took place (Weeks 12, 17 and 24). Sleep characteristics and the sleep-wake rhythm were assessed using actigraphy (GENEActiv). Mood was measured with the Anxiety, Depression and Mood Scale (ADAMS) and behaviour with the Aberrant Behaviour Checklist (ABC). RESULTS Mixed-effect regression analysis showed a worsening of the primary outcome interdaily stability (P = 0.001). This could be attributed to one care facility, whereas interdaily stability did not change in the other care facilities (P = 0.74). Dynamic lighting led to earlier mid-sleep (P = 0.003) and sleep onset (P < .0001) and improved mood as indicated by lower scores on the ADAMS depression (-0.64 SD, P < 0.001) and social avoidance (-0.47 SD, P = 0.004) subscales. The prevalence of screening above cut-off for depression decreased from 23 to 9.8% (OR = .16, P = 0.003). For behaviour, a decrease was seen in hyperactivity (-0.43 SD, P < 0.001), lethargy (-0.35 SD, P = 0.008) and irritability (-0.33 SD, P < .001) as measured with the ABC. No adverse effects were reported. CONCLUSION Installing dynamic lighting in common living areas for older adults with ID improved the mood and behaviour of the residents up to 14 weeks after placement. Integrated dynamic lighting is a promising, undemanding and potentially effective addition to improve mood and behaviour in care organisations for people with ID, but does not seem to do so by improving sleep or sleep-wake rhythms.
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Affiliation(s)
- M. N. Böhmer
- Department of General Practice, Intellectual Disability MedicineErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- MiddinRijswijkThe Netherlands
| | - A. Oppewal
- Department of General Practice, Intellectual Disability MedicineErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - M. J. Valstar
- Department of General Practice, Intellectual Disability MedicineErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Medical DepartmentASVZ, Care and Service Centre for People with Intellectual DisabilitiesSliedrechtThe Netherlands
| | - P. J. E. Bindels
- Department of General PracticeErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - E. J. W. van Someren
- Department of Sleep and CognitionNetherlands Institute for NeuroscienceAmsterdamThe Netherlands
- Department of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus AmsterdamVrije UniversiteitAmsterdamThe Netherlands
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Dept. of PsychiatryAmsterdam Public Health Research IllnstituteAmsterdamThe Netherlands
| | - D. A. M. Maes‐Festen
- Department of General Practice, Intellectual Disability MedicineErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Ipse de BruggenZoetermeerThe Netherlands
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Gore N, Bradshaw J, Hastings R, Sweeney J, Austin D. Early positive approaches to support (E-PAtS): Qualitative experiences of a new support programme for family caregivers of young children with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:889-899. [PMID: 35289031 PMCID: PMC9311085 DOI: 10.1111/jar.12993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Early Positive Approaches to Support (E-PAtS) is a co-produced and co-facilitated group programme that aims to provide early years support to family caregivers of children with Intellectual and Developmental Disabilities. METHOD Thirty-five caregivers who had attended E-PAtS groups took part in individual interviews or focus groups. Caregiver experiences concerning attendance of E-PAtS were explored, in relation to process variables and perceived outcomes. Interviews were thematically analysed. RESULTS Three major themes were identified: our group, evolving emotions, and positive approaches. Being with and being supported by other families was very important to caregivers. Families reported increased confidence and greater realisation of the need for self-care. Children were reported to show fewer behaviours that challenge and increases in adaptive skills. Findings corresponded to mechanisms and outcomes in the E-PAtS logic model. CONCLUSION E-PAtS shows promise as one way families and children with Intellectual and Developmental Disabilities can access early years support.
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Affiliation(s)
- Nick Gore
- Tizard Centre, Cornwallis North East, University of Kent, Canterbury, Kent, UK
| | - Jill Bradshaw
- Tizard Centre, Cornwallis North East, University of Kent, Canterbury, Kent, UK
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Ng R, Bjornsson HT, Fahrner JA, Harris J. Sleep disturbances correlate with behavioral problems among individuals with Wiedemann-Steiner syndrome. Front Genet 2022; 13:950082. [PMID: 36313433 PMCID: PMC9608624 DOI: 10.3389/fgene.2022.950082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Wiedemann-Steiner syndrome (WSS) is a rare genetic disorder caused by mutation in KMT2A and characterized by neurodevelopmental delay. This study is the first prospective investigation to examine the sleep and behavioral phenotypes among those with WSS through parent-informant screening inventories. A total of 24 parents of children/adults with WSS (11F, Mean age = 12.71 years, SD = 8.17) completed the Strengths and Difficulties Questionnaire (SDQ) and 22 of these caregivers also completed the Modified Simonds and Parraga Sleep Questionnaire (MSPSQ). On average, the majority of those with WSS (83%) were rated to show borderline to clinical level of behavioral difficulties on the SDQ. Approximately 83% were rated in these ranges for hyperactivity, 63% for emotional problems, and 50% for conduct problems. When applying prior published clinical cut-off for risk of sleep disturbance among those with neurodevelopmental disorders, over 80% of our sample exceeded this limit on the MSPSQ. Largely, caregivers' ratings suggested restless sleep, rigid bedtime rituals, sleep reluctance and breathing through the mouth in sleep were most consistent problems observed. Partial correlations between sleep and behavioral domains showed elevated emotional problems were associated with parasomnia characteristics after controlling for age. Daytime drowsiness and activity were associated with more hyperactivity. Those with more night waking problems and delayed sleep onset were rated to show more severe conduct problems. Overall, these findings suggest dysfunctional sleep behaviors, hyperactivity, and affective problems are part of the neurobehavioral phenotype of WSS. Routine clinical care for those affected by WSS should include close monitoring of sleep and overactive behaviors.
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Affiliation(s)
- Rowena Ng
- Kennedy Krieger Institute, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hans Tomas Bjornsson
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Landspitali University Hospital, Reykjavik, Iceland
| | - Jill A Fahrner
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jacqueline Harris
- Kennedy Krieger Institute, Baltimore, MD, United States.,Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Harper L, Ooms A, Tuffrey Wijne I. The impact of nutrition on sleep in people with an intellectual disability: An integrative literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1393-1407. [PMID: 34212459 DOI: 10.1111/jar.12911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/25/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with intellectual disabilities are more likely to experience sleep problems. Sleep can impact on health and well-being; therefore, evidence-based interventions are required to improve sleep in this population. METHOD An integrative literature review was conducted on the impact of nutrition on sleep in people with intellectual disabilities. Following screening of papers (n = 289), 14 papers met the inclusion criteria. RESULTS Themes related to nutrition and improved overall well-being, use of nutritional supplements, specific foods, links to health comorbidities and food fussiness. CONCLUSION This is the first comprehensive review completed on nutritional interventions to improve sleep in people with intellectual disabilities. Dietary patterns may be an important factor to improving the quality and quantity of sleep. However, the current literature regarding the benefit of improved nutrition on sleep in people with an intellectual disability needs to be interpreted with caution.
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Affiliation(s)
- Lynette Harper
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Ann Ooms
- Kingston University and St Georges University, London, UK
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Zečević I. Behavioral Management in Encephalitis Rehabilitation: Review of Clinical Research with Clinical Recommendations. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-021-00390-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Alcántara C, Giorgio Cosenzo L, McCullough E, Vogt T, Falzon AL, Perez Ibarra I. Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: A systematic review of randomized controlled trials in the United States. Sleep Med Rev 2021; 56:101455. [PMID: 33735638 DOI: 10.1016/j.smrv.2021.101455] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/16/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Psychological interventions for sleep-wake disorders have medium-to-large effect sizes, however whether behavioral randomized controlled trials (RCTs) targeted underserved populations or addressed contextual and cultural factors is unknown. We conducted a systematic review to: (a) examine sociodemographic characteristics of behavioral RCTs for prevalent sleep-wake disorders and sleep disturbances that targeted undeserved adults, (b) identify types of cultural adaptations (surface-level, deep-level), and (c) describe intervention effectiveness on primary sleep outcomes. Overall, 6.97% of RCTs (56 studies) targeted underserved groups (veterans, women, racial/ethnic minorities, low socioeconomic status, disability status); 64.29% made surface-level and/or deep-level cultural adaptations. There was a lack of racial/ethnic, socioeconomic, sexual orientation, and linguistic diversity. Most cultural adaptations were made to behavioral therapies, and cognitive behavioral therapy for insomnia (CBT-I). Surface-level cultural adaptations to the delivery modality and setting were most common. Deep-level cultural adaptations of the content and core intervention components were also typical. Intervention effectiveness varied by type of adapted intervention and participant population. RCTs of adapted CBT-I interventions among participants with a definite sleep disorder or sleep disturbance showed consistent significant reductions in adverse sleep outcomes versus control. These findings have important implications for the use of cultural adaptations to address behavioral sleep medicine disparities.
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Affiliation(s)
- Carmela Alcántara
- School of Social Work, Columbia University, New York, NY, 10027, USA.
| | | | - Elliot McCullough
- School of Social Work, Columbia University, New York, NY, 10027, USA
| | - Tiffany Vogt
- School of Social Work, Columbia University, New York, NY, 10027, USA
| | - Andrea L Falzon
- Feinstein Institute for Medical Research, Northwell Health, New York, NY, USA
| | - Irene Perez Ibarra
- Aragonese Foundation for Research, Zaragoza, Spain; AgriFood Institute of Aragon, University of Zaragoza, Spain
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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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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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Williams EM, Rose J. Nonpharmacological treatment for individuals with intellectual disability and "personality disorder". JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 33:767-778. [PMID: 30182462 DOI: 10.1111/jar.12527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/27/2018] [Accepted: 08/11/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research exploring nonpharmacological interventions for individuals with intellectual disability and personality disorder was reviewed. This should prove valuable to services and professionals contemplating how to offer interventions for these individuals. METHOD A systematic search of electronic databases was conducted. Articles were considered for inclusion according to criteria based on the PICOS model. The quality of the research was assessed utilizing the evaluative method for determining evidence-based practice. RESULTS Eleven studies were reviewed with quality assessment indicating that all provided weak research evidence. Consistent flaws included insufficient description of participants and lack of control groups. CONCLUSIONS The research base exploring nonpharmacological interventions for individuals with intellectual disabilities and personality disorder includes many methodological flaws but reveals some useful information regarding the characteristics of these individuals and components of interventions to support them. Further research is needed to identify the differential effectiveness of interventions over and above other confounding factors.
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Affiliation(s)
- Emma M Williams
- Centre for Applied Psychology, School of Psychology, The University of Birmingham, Birmingham, UK
| | - John Rose
- Centre for Applied Psychology, School of Psychology, The University of Birmingham, Birmingham, UK
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Surtees AD, Oliver C, Jones CA, Evans DL, Richards C. Sleep duration and sleep quality in people with and without intellectual disability: A meta-analysis. Sleep Med Rev 2018; 40:135-150. [DOI: 10.1016/j.smrv.2017.11.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/06/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
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Robertson J, Baines S, Emerson E, Hatton C. Postural care for people with intellectual disabilities and severely impaired motor function: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 31 Suppl 1:11-28. [DOI: 10.1111/jar.12325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Janet Robertson
- Centre for Disability Research; Division of Health Research; Faculty of Health and Medicine; Lancaster University; Lancaster UK
| | - Susannah Baines
- Centre for Disability Research; Division of Health Research; Faculty of Health and Medicine; Lancaster University; Lancaster UK
| | - Eric Emerson
- Centre for Disability Research; Division of Health Research; Faculty of Health and Medicine; Lancaster University; Lancaster UK
- Centre for Disability Research and Policy; University of Sydney; Lidcombe NSW Australia
| | - Chris Hatton
- Centre for Disability Research; Division of Health Research; Faculty of Health and Medicine; Lancaster University; Lancaster UK
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