Insomnia, especially sleep-onset association disorder type, is common among children with neurodevelopmental disabilities, though more often studied under the heading of sleep problems than in its own right. It has been defined as difficulty with sleep initiation, maintenance, and/or sleep quality that is persistent and impairing, and multiple prior diagnostic subtypes have been folded into a single category. Effects of insomnia in children on family sleep and dynamics can be significant. Not all sleep problems constitute insomnia, as, for instance, external forces can deprive children of adequate opportunity for sleep. Current practice suggests detailed evaluation for and treatment of any medical and psychiatric contributors, the use of behavioral and environmental strategies, and potential medication use to alleviate symptoms. Relevant future directions for study are manifold and involve moving away from describing the scope of the problem and toward more detailed phenotyping and applications for treatment.
KeywordsChildren Neurodevelopmental disabilities Insomnia Inadequate sleep Short sleep duration Behavioral insomnia of sleep Sleep problems
Cognitive behavioral therapy for insomnia
Diagnostic and Statistical Manual of Mental Disorders, 5th edition
Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision
International Classification of Sleep Disorders-3rd edition
Individualized Education Program
Obstructive sleep apnea
Rapid eye movement
- 1.American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien: American Academy of Sleep Medicine; 2014.Google Scholar
- 2.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.Google Scholar
- 13.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1980.Google Scholar
- 16.Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin N Am. 1987;10(4):541–53.Google Scholar
- 25.Meltzer LJ, Moore M. Sleep disruptions in parents of children and adolescents with chronic illnesses: prevalence, causes, and consequences. J Ped Psychol. 2008;33(3):279–91.Google Scholar
- 26.Meltzer LJ. Brief report: sleep in parents of children with autism spectrum disorders. J Ped Psychol. 2008;33(4):380–6.Google Scholar
- 27.Hiscock H, Sciberras E, Mensah F, Gerner B, Efron D, Khano S, Oberklaid F. Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomized controlled trial. BMJ. 2015;350:h68.PubMedPubMedCentralGoogle Scholar
- 31.Caffeine Informer website. https://www.caffeineinformer.com/the-caffeine-database. Accessed 31 Mar 2018.
- 33.Owens JA, Spirito A, McGuinn M. The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2000;23(8):1–9.Google Scholar
- 35.Start School Later website. www.startschoollater.net. Accessed 19 Feb 2018.
- 37.Kotagal S. Sleep-wake disorders of childhood. Continuum (Minneap Minn). 2017;23(4):1132–50.Google Scholar
- 38.Malow BA, Byars K, Johnson K, Weiss S, Bernal P, Goldman SE, et al. A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders. Pediatrics. 2012;130(Suppl 2):24. https://doi.org/10.1542/peds.2012-0900I.CrossRefGoogle Scholar
- 49.National Sleep Foundation. Sleep in America poll: sleep in the modern family. Washington, DC: The Foundation; 2014; 2014 Mar. Available from: http://www.sleepfoundation.org/sleep-polls-data/sleep-in-americapoll/2014-sleep-in-the-modern-family. Accessed 3 March 2018.Google Scholar
- 50.Adolescent Sleep Working Group, Committee on Adolescence, Council on School Health. School start times for adolescents. Pediatrics. 2014;134(3):642–9.Google Scholar
- 52.American Sleep Disorders Association and Sleep Research Society. Practice parameters for the use of actigraphy in the clinical assessment of sleep disorders. Sleep. 1997;18(4):285–7.Google Scholar
- 59.Autism Speaks website. ATN/AIR-P sleep tool kits. https://www.autismspeaks.org/science/resources-programs/autism-treatment-network/tools-you-can-use/sleep-tool-kit. Accessed 22 May 2018.