Sleep Problems

Sleep Problems

Screen for sleep problems

Screen regularly for sleep problems and for associated caregiver stress.239 Review with and educate patients and their caregivers on helpful sleep hygiene practices.240

Sleep problems (eg, difficulties settling, night walking or early awakening) are common among adults with IDD and often result in increased caregiver stress.239

Review medications and factors that affect sleep

Review medications that might negatively affect sleep and other physical health issues, as well as environmental, life experience and psychiatric issues that might be causing sleep problems.239

   Recommended

Sleep problems can be caused by physical health issues(eg, GERD, pain that the person with IDD might be unable to communicate, 241 or obstructive sleep apnea; environmental factors (eg, noise, electronic screen time); distressing life experiences (eg, bereavement or adjustment to change); or effects of medications (eg, certain psychotropics, antiepileptics, and antidepressants). Also, behaviours that challenge and psychiatric disorders can be associated with sleep disturbance.239

Assess for sleep apnea

Assess for obstructive sleep apnea in patients, especially those who are obese (see Physical Inactivity and Obesity) and those with craniofacial abnormalities or certain genetic disorders (eg, Down syndrome).241-243

  Recommended

Empirical Expert

Sleep problems can be caused by physical health issues(eg, GERD, pain that the person with IDD might be unable to communicate, 241 or obstructive sleep apnea; environmental factors (eg, noise, electronic screen time); distressing life experiences (eg, bereavement or adjustment to change); or effects of medications (eg, certain psychotropics, antiepileptics, and antidepressants). Also, behaviours that challenge and psychiatric disorders can be associated with sleep disturbance.239

Refer to behaviour or occupational therapist

Refer to a behaviour therapist or occupational therapist familiar with people with IDD to assess or address sleep hygiene and environmental factors.240

   Recommended

Adults with IDD and sleep problems can benefit from behavioural interventions, such as sleep hygiene training or environmental modifications.239

Sleep chart: Monthly 24-hour sleep record

Use the [INTERNAL link tool] Sleep chart: Monthly 24-hour sleep record [close link] tool, developed by the Developmental Disabilities Primary Care Initiative at Surrey Place (Toronto, 2011) for tracking sleep patterns over a period of one month.

239. van de Wouw E, Evenhuis HM, Echteld MA. Prevalence, associated factors and treatment of sleep problems in adults with intellectual disability: A systematic review. Res Dev Disabil. 2012;33(4):1310-32.

240. Heussler HS. Management of sleep disorders in neurodevelopmental disorders and genetic syndromes. Curr Opin Psychiatry. 2016;29(2):138-43.

241. Stores G. Sleep and its disorders in children and adolescents with a neurodevelopmental disorder: A review and clinical guide. Cambridge University Press; 2014.

242. Wallace RA, Dalton AJ. Clinicians’ guide to physical health problems of older adults with down syndrome. Journal on Developmental Disabilities. 2006;12(1 (Supplement 1)):1-92.

243. Lal C, White DR, Joseph JE, van Bakergem K, LaRosa A. Sleep-disordered breathing in down syndrome. Chest. 2015;147(2):570-9.

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