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
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
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
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
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.