Sleep problems and daytime challenging behaviour in a community-based sample of adults with intellectual disability.
Poor sleep and tough daytime behaviors stick together in adults with ID, so screen sleep before treating behavior.
01Research in Context
What this study did
The team asked adults with intellectual disability about sleep and daytime behavior. They used a survey, not an experiment. They wanted to see if poor sleep and tough daytime behaviors travel together.
What they found
Adults who slept badly also showed more self-injury, aggression, and non-compliance. The link was strong, but the study cannot tell us which came first.
How this fits with other research
Staddon et al. (2002) asked the same questions about kids and got the same answer: bad sleep equals more problem behavior. The pattern holds across age groups.
Kanter et al. (2010) went further. They gave melatonin to adults and kids with ID and chronic insomnia. Sleep improved and daytime challenging behavior dropped, showing the link may be causal.
Madden et al. (2003) used a behavioral sleep package instead of pills. Six of nine adults slept better after the plan. Again, better sleep came with calmer days.
Rzepecka et al. (2011) added anxiety to the mix. In kids with ID or ASD, sleep plus anxiety explained nearly half of challenging behavior. Sleep alone is only part of the story.
Why it matters
Before you write a behavior plan, ask about sleep. A simple parent or staff interview can flag trouble. If nights are rough, try a sleep intervention first—pills or behavioral—and watch daytime behaviors fall. You may fix the function without a full FBA.
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02At a glance
03Original abstract
The present study aimed to explore associations between sleep problems and daytime challenging behaviour in a community sample of adults with intellectual disability. Sleep and behaviour questionnaires were completed for 205 people aged 18 years or over living in health- or social-services-managed community housing. This sample represented an 86% return rate. The informants were carers and the individuals themselves where possible. Seventy-nine people with sleep problems were compared with 121 individuals without this difficulty; five people were excluded from the analysis. Individuals with sleep problems displayed significantly more daytime irritability, stereotypy and hyperactivity than those without sleep problems. Individuals displaying clinically significant aggression/temper, self-injury and screaming were significantly more likely to have a concurrent sleep problem, and these forms of challenging behaviour were significantly more severe in the sleep problem group. Associations between sleep problems and daytime challenging behaviour exist in this population, although the nature of any links remains unclear and should be the attention of future research.
Journal of intellectual disability research : JIDR, 1999 · doi:10.1046/j.1365-2788.1999.00234.x