Sleep problems and daytime problem behaviours in children with intellectual disability.
One in six kids with ID has severe sleep issues, and those kids act out more during the day.
01Research in Context
What this study did
Staddon et al. (2002) asked parents of children with intellectual disability about sleep and daytime behavior. They used a mailed survey to count how many kids had severe sleep trouble. They also asked about aggression, non-compliance, and hyperactivity during the day.
What they found
One in six children had at least one severe sleep problem. Those same children also showed more aggression, non-compliance, and hyperactivity while awake. Medical issues like epilepsy were more common in the poor-sleep group.
How this fits with other research
The finding builds on two earlier studies. Einfeld et al. (1996) showed every child in a small severe-ID sample had sleep issues. Webb et al. (1999) found the same link in adults. Staddon et al. (2002) now gives a number: about 16% of kids.
Later work extends the story. Kanter et al. (2010) ran an RCT and proved melatonin pills cut both insomnia and daytime challenging behavior. Rzepecka et al. (2011) added anxiety to the mix, showing sleep plus anxiety explain nearly half of behavior variance.
One twist: Porter et al. (2008) treated three adults with melatonin. Behavior improved even when wrist-watch data showed almost no extra sleep. This hints the sleep-behavior link may run through circadian timing, not just total sleep minutes.
Why it matters
Before you write a behavior plan, ask about sleep. A quick parent checklist can flag the one in six kids who may need a sleep intervention first. If sleep is bad, consider melatonin or other sleep supports before intensifying behavioral consequences. Fixing nights can calm days.
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02At a glance
03Original abstract
BACKGROUND: Sleep problems are common among children with intellectual disability (ID). METHOD: The present study assessed the prevalence of severe sleep problems in a sample of children (n=286) with mild to profound ID who lived at home with their parents(s) in the Netherlands. It also explored relationships between severe sleep problems, and family and child variables. Demographic information, data on children's sleep behaviours and parent variables were collected using questionnaires. RESULTS: Severe settling problems, night waking and early waking were present in 4.2%, 10.8% and 4.2% of cases, respectively; 16.1% of children had at least one type of sleep problem. Children with a severe sleep problem had more severe levels of ID, used medication more often, had a greater frequency of epilepsy, were younger, had a greater frequency of cerebral palsy, and showed more daytime drowsiness and daytime napping than children without a severe sleep problem. Furthermore, children with a severe sleep problem showed more severe levels of daytime problem behaviours; for example, aggression, non-compliance and hyperactivity. CONCLUSION: The results of the present study are discussed with regard to the assessment and treatment of sleep problems in children with ID.
Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00404.x