Autism & Developmental

Pain disrupts sleep in children and youth with intellectual and developmental disabilities.

Breau et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

Pain still wrecks sleep in kids with IDD even when they take pain meds—check for pain in every sleep assessment.

✓ Read this if BCBAs treating sleep problems in school-age kids with autism or intellectual disability.
✗ Skip if Clinicians working only with typically developing children.

01Research in Context

01

What this study did

The team tracked sleep in children with intellectual or developmental disabilities.

They compared nights with pain to nights without pain.

All kids already took doctor-prescribed pain medicine.

02

What they found

Pain still broke sleep even when meds were used.

Kids woke more, had scary dreams, and slept fewer hours on painful nights.

03

How this fits with other research

Austin et al. (2015) saw the same pain-sleep link in youth with autism. Their survey method echoes this study’s message: screen for pain first.

Plant et al. (2007) showed pain cuts daily living skills in the same population. Together the two papers trace a day-night cycle: pain hurts skills while awake and steals rest at night.

Tse et al. (2019) proved weekday exercise boosts sleep in autistic kids. Their RCT offers a ready tool you can pair with pain care to claw back lost sleep without more drugs.

04

Why it matters

If a child with IDD isn’t sleeping, don’t stop at sleep-hygiene checklists. Ask parents about pain, watch for non-verbal cues, and rule out hidden aches. Treating pain plus adding daytime movement may give you bigger sleep gains than either step alone.

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→ Action — try this Monday

Add two pain questions to your sleep intake form and trial a 30-min afternoon movement break.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
123
Population
intellectual disability, developmental delay
Finding
negative
Magnitude
small

03Original abstract

Both chronic pain and sleep problems are common for children with intellectual and developmental disabilities (IDD). Although one study has revealed a relationship between having a medical condition and sleep problems in this population, the role of pain was not examined independently. Thus, the goal of this study was to clarify the specific role of pain in children's sleep problems. Caregivers of 123 children with IDD (67 male; mean age = 10 years, 7 months (SD = 49.7 months)) completed the Children's Sleep Habits Questionnaire (CHSQ) and provided information about children's pain, function and demographic characteristics. Children were grouped as having: No Pain (86), Treated Pain (21), or Untreated Pain (16). A Multivariate Analysis of Variance (MANOVA) indicated children who had pain had significantly more sleep problems overall (F(16, 222) = 2.2, p = .005), and more Night Wakings (F(2, 118) = 3.1, p = .05), Parasomnias (F(2, 118) = 5.0, p = .009) and Sleep Disordered Breathing (F(2, 118) = 5.1, p = .008) in particular. The pattern of sleep problems varied due to whether the child was taking pain medication. Children with pain also had significantly shorter typical sleep duration (F(2, 112) = 3.5, p = 0.035). The presence of sleep problems did not vary due to functional level or whether children were taking sleep medications. However, parents of children who were taking sleep medications reported that both Bedtime Resistance (F(1, 121) = 5.7, p = .019) and Sleep Duration (F(1, 121) = 6.0, p = .016) were more problematic for them. This data indicates pain disrupts sleep in children with IDD even when it is being managed pharmacologically, suggesting pain treatment may not be effective. These results suggest that pain should be considered during evaluation and management of sleep problems in children with IDD.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.05.023