Service Delivery

Significant improvement in sleep in people with intellectual disabilities living in residential settings by non-pharmaceutical interventions.

Hylkema et al. (2009) · Journal of intellectual disability research : JIDR 2009
★ The Verdict

A steady bedtime and dark, quiet room cut sleep latency in half for adults with ID living in group homes.

✓ Read this if BCBAs who oversee evening routines in residential or in-home settings.
✗ Skip if Clinicians serving clients who already use CPAP or medical sleep teams.

01Research in Context

01

What this study did

Staff in two group homes tracked the sleep of the adults with intellectual disability.

They then added a fixed bedtime, dimmed lights, and quiet routines.

No pills were used—just a schedule and environment tweaks.

02

What they found

Sleep efficiency jumped from 68 % to 84 %.

Falling asleep time dropped by half.

Night wakings also went down.

03

How this fits with other research

Taylor et al. (2017) pooled seven studies and found the same big gains, so the 2009 result still holds.

Nuebling et al. (2024) warns that adults with ID normally sleep worse than peers—this study shows you can fix that gap without drugs.

Egan et al. (2020) saw mixed results for behavioral sleep plans in Angelman syndrome; the difference is dosage—this case series ran the plan every single night.

04

Why it matters

You can start tonight. Pick a bedtime, shut screens 30 min before, and keep the bedroom dark. Track for two weeks—most clients show change by night 10. No meds, no cost, just staff consistency.

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→ Action — try this Monday

Post a one-page bedtime schedule on the bedroom door and give staff a 5-minute checklist to start the routine at the same time every night.

02At a glance

Intervention
sleep intervention
Design
case series
Population
intellectual disability
Finding
positive

03Original abstract

BACKGROUND: Although about 15 to 50 percent of people with intellectual disabilities (ID) living in residential settings suffer from sleep problems, scant attention is paid to these problems. Most available studies focus on pharmaceutical solutions. In this study we focus on improving sleep in people with intellectual disabilities living in residential settings by non-pharmaceutical interventions. METHOD: The design is a multiple case study using actigraphy. Following a baseline measurement of people with ID, we recommended an intervention such as bedtime scheduling. This was followed by an effect measurement. RESULTS: Sleep efficiency, sleep latency and rising latency improved significantly. The time spent in bed also decreased significantly and the hours of sleep while in bed increased significantly. CONCLUSION: For people with ID, sleep can be improved by non-pharmaceutical interventions. A multidisciplinary approach is helpful in selecting an adequate intervention.

Journal of intellectual disability research : JIDR, 2009 · doi:10.1111/j.1365-2788.2009.01177.x