Prevalence, associated factors and treatment of sleep problems in adults with intellectual disability: a systematic review.
Up to one-third of adults with ID have sleep problems tied to behavior, health, and meds, yet we still lack clear tools to spot and fix it.
01Research in Context
What this study did
Meier et al. (2012) looked at every paper they could find on sleep problems in adults with intellectual disability. They wanted to know how common these problems are and what might cause them.
The team pulled data from many studies. They counted how many adults had sleep trouble. They also noted links to challenging behavior, medical issues, and psychoactive drugs.
What they found
Sleep problems hit up to one in three adults with ID. Rates ranged from 8.5% to 34%.
Poor sleep went hand in hand with aggression, self-injury, and health issues like epilepsy. Medications for mood or behavior often made sleep worse.
How this fits with other research
Bao et al. (2017) and van Timmeren et al. (2016) show that adults with severe ID often have many health issues at once. Their work adds weight to the sleep review's point that one problem rarely travels alone.
Heald et al. (2020) and Garwood et al. (2021) found high rates of psychotropic drug use in the same group. These papers support the sleep review's warning that meds can disturb sleep.
O'Dwyer et al. (2018) links problem behavior to psychotropic use in older Irish adults. This matches the sleep review's finding that poor sleep and challenging behavior feed each other.
Why it matters
If you serve adults with ID, treat sleep as a vital sign. Ask about bedtime routines, pain, and current meds. Start a simple sleep log for one week. Share the log with the doctor before adding new drugs. Better sleep can cut daytime aggression and boost learning readiness.
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02At a glance
03Original 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.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.03.003