Sleep in people with and without intellectual disabilities: a systematic review and meta-analysis.
Expect shorter, poorer sleep in clients with ID—especially those with genetic syndromes—and screen accordingly.
01Research in Context
What this study did
Nuebling et al. (2024) pooled 67 sleep studies. They compared people with intellectual disability to same-age peers without ID.
The team looked at total sleep time, how fast people fell asleep, and how often they woke up. They also checked if the cause of ID—like Down, Angelman, or Smith-Magenis—changed the picture.
What they found
Across all studies, people with ID slept 40 minutes less per night. They took twice as long to fall asleep and woke up almost twice as often.
The gap grew larger when the ID came from a known genetic syndrome. Clients with Angelman or Smith-Magenis showed the shortest, most broken sleep.
How this fits with other research
Taylor et al. (2017) showed behavioral sleep plans give big, quick gains for people with ID. Nuebling et al. (2024) now tells us those clients start from a much lower baseline, so the need is even greater.
Egan et al. (2020) found only weak proof for Angelman sleep plans. Nuebling et al. (2024) explains why: Angelman sleep is unusually poor, so single studies may miss small but real effects.
Lippold et al. (2009) proved simple bedtime rules work in group homes. The new meta-analysis widens the lens—sleep is short everywhere in ID, not just in facilities.
Why it matters
Screen sleep first. Short, broken nights can mimic or worsen problem behavior. Use a one-week sleep log and actigraphy if you can. When you see less than 7 hours, long sleep latency, or many night wakes, move fast—especially with clients who have a named genetic syndrome. Pair your behavior plan with medical checks; pain, reflux, and sleep apnea are common in these groups. Better sleep can boost daytime learning and cut challenging behavior before you start formal programs.
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02At a glance
03Original abstract
BACKGROUND: Sleep problems are regularly reported in people with intellectual disabilities. Recent years have seen a substantial increase in studies comparing sleep in people with intellectual disabilities to control participants, with an increase in the use of validated, objective measures. Emerging patterns of differences in sleep time and sleep quality warrant pooled investigation. METHODS: A systematic search was conducted across three databases (Ovid Embase, PsycInfo and Medline) and returned all papers comparing sleep in people with intellectual disabilities to a control group, published since the last meta-analysis on the topic. A quality framework was employed to rate the risk of bias across studies. Separate meta-analyses of sleep duration and sleep quality were conducted. Subgrouping compared findings for those studies with participants with genetic syndromes or neurodevelopmental conditions and those with heterogeneous intellectual disability. RESULTS: Thirteen new papers were identified and combined with those from the previous meta-analysis to provide 34 papers in total. Quality of studies was generally rated highly, though sampling provided risk of bias and adaptive functioning was rarely measured. People with intellectual disability associated with genetic syndromes or neurodevelopmental conditions sleep for shorter time periods (standardised mean difference = .26) and experience worse sleep quality (standardised mean difference = .68) than their peers. People with intellectual disability of heterogeneous origin show no difference in sleep time but have poorer sleep quality. There was some evidence that age moderated these effects. CONCLUSIONS: People with intellectual disability have poorer sleep than those without. Subtle patterns suggest that aetiology of intellectual disability moderates the topography of these difficulties, with further work needed to differentiate common and distinct mechanisms across groups.
Journal of intellectual disability research : JIDR, 2024 · doi:10.1111/jir.13093