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Behavioral Sleep Interventions

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Abstract

Many children and adolescents with neurodevelopmental disabilities (NDD) have problematic sleep, including delayed sleep initiation, poor sleep maintenance, sleep-onset association disorder, early morning awakenings, or difficulty waking. Disrupted sleep can negatively impact a child’s behavior, attention, alertness, and overall functioning. The importance of good sleep, including in children with NDD, has gained more attention and led to increased efforts to identify effective treatments for sleep problems. This chapter describes behavioral interventions that can be used to treat a wide variety of sleep concerns, with a particular emphasis on interventions used to target difficulty initiating sleep, difficulty maintaining sleep, and difficulty waking. A case example illustrates the real-world application of many of the described strategies. Additional guidelines provide behavioral sleep recommendations for children with NDD and a brief discussion of the need for additional empirical research on the effectiveness of behavioral sleep interventions for children with NDD.

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Abbreviations

ADHD:

Attention-deficit/hyperactivity disorder

ASD:

Autism spectrum disorder

NDD:

Neurodevelopmental disability/disabilities

REM:

Rapid eye movement

References

  1. Allen KD, Kuhn DR, DeHaai KA, Wallace DP. Evaluation of a behavioral treatment package to reduce sleep problems in children with Angelman syndrome. Res Dev Disabil. 2013;34(1):676–86.

    Article  Google Scholar 

  2. Bonuck K, Grant R. Sleep problems and early developmental delay: implications for early intervention. Intellect Dev Disabil. 2012;50(1):41–52.

    Article  Google Scholar 

  3. Courturier JL, Speechley KN, Steele M, Norman R. Parental perception of sleep problems in children of normal intelligence with pervasive developmental disorder: prevalence, severity, and pattern. J Am Acad Child Adolesc Psychiatry. 2005;44(8):815–22.

    Article  Google Scholar 

  4. Dorris L, Scott N, Zuberi S, et al. Sleep problems in children with neurological disorders. Dev Neurorehabil. 2008;11(2):95–114.

    Article  Google Scholar 

  5. Krakowiak P, Goodlin-Jones B, Hertz-Picciotto I, et al. Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: a population-based study. J Sleep Res. 2008;17(2):197–206.

    Article  Google Scholar 

  6. Patel DM, Rocque BG, Hopson B, et al. Sleep-disordered breathing in patients with myelomeningocele. J Neurosurg Pediatr. 2015;3:1–6.

    Google Scholar 

  7. Weiskop S, Richdale A, Matthews J. Behavioral treatment to reduce sleep problems in children with autism or fragile X syndrome. Dev Med Child Neurol. 2005;47:94–104.

    Article  Google Scholar 

  8. Spruyt K, Curfs LMG. Non-pharmacological management of problematic sleeping in children with developmental disabilities. Dev Med Child Neurol. 2015;57:120–36.

    Article  Google Scholar 

  9. Mindell JA, Kuhn B, Lewin DS, et al. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006;29:1263–76.

    Google Scholar 

  10. Mindell JA, Owens JAA. Clinical guide to pediatric sleep: diagnosis and management of sleep problems. 3rd ed. Philadelphia: Wolters Kluwer; 2015.

    Google Scholar 

  11. Malow BA, Byars K, Johnson K, et al. A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders. Pediatrics. 2012;130(S2):S106–24.

    Article  Google Scholar 

  12. Keenan RA, Wild MR, McArthur I, Espie CA. Children with developmental disabilities and sleep problems: parental beliefs and treatment acceptability. J Appl Res Intellect Disabil. 2007;20:455–65.

    Article  Google Scholar 

  13. Jan JE, Owens JA, Weiss MD, et al. Sleep hygiene for children with neurodevelopmental disabilities. Pediatrics. 2008;122(6):257–60.

    Article  Google Scholar 

  14. Vriend JL, Corkum PV, Moon EC, Smith IM. Behavioral interventions for sleep problems in children with autism spectrum disorders: current findings and future directions. J Pediatr Psychol. 2011;36(9):1017–29.

    Article  Google Scholar 

  15. Weiss MD, Wasdell MB, Bomben MM, et al. Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia. J Am Acad Child Adolesc Psychiatry. 2006;45(5):512–9.

    Article  Google Scholar 

  16. Van der Heijden KB, Smits MG, Van Someren EJ, et al. Idiopathic chronic sleep onset insomnia in attention-deficit/hyperactivity disorder: a circadian rhythm disorder. Chronobiol Int. 2005;22:559–70.

    Article  Google Scholar 

  17. Christodulu KV, Durand VM. Reducing bedtime disturbance and night waking using positive bedtime routines and sleep restriction. Focus Autism Other Dev Disabil. 2004;19(3):130–9.

    Article  Google Scholar 

  18. Weiskop S, Matthews J, Richdale A. Treatment of sleep problems in a 4-year-old boy with autism using behavioral principles. Autism. 2001;5:209–21.

    Article  CAS  Google Scholar 

  19. Keshavarzi Z, Bajoghli H, Mohamadi MR, et al. In a randomized case-control trial with 10-years olds suffering from attention deficit/hyperactivity disorder (ADHD) sleep and psychological functioning improved during a 12-week sleep-training program. World J Biol Psychiatry. 2014;15:609–19.

    Article  Google Scholar 

  20. Piazza CC, Fisher WW. A faded bedtime with response cost protocol for treatment of multiple sleep problems in children. J Appl Behav Anal. 1991;24:129–40.

    Article  CAS  Google Scholar 

  21. DeLeon I, Fisher W, Marhefka J. Decreasing self-injurious behavior associated with awakening in a child with autism and developmental delays. Behav Interv. 2004;19(2):111–9.

    Article  Google Scholar 

  22. Didden R, Curfs LMG, van Driel S, de Moor JMH. Sleep problems in children and young adults with developmental disabilities: home-based functional assessment and treatment. J Behav Ther Exp Psychiatry. 2002;33:49–58.

    Article  Google Scholar 

  23. Lancioni GE, O’Reilly MF, Basili G. Review of strategies for treating sleep problems in persons with severe and profound mental retardation or multiple handicaps. Am J Ment Retard. 1999;104:170–86.

    Article  CAS  Google Scholar 

  24. Wiggs L, France K. Behavioural treatments for sleep problems in children and adolescents with physical illness, psychological problems or intellectual disabilities. Sleep Med Rev. 2000;4:299–314.

    Article  Google Scholar 

  25. Mindell JA, Owens JA. A clinical guide to pediatric sleep: diagnosis and management of sleep problems. Philadelphia: Lippincott Williams & Wilkins; 2003.

    Google Scholar 

  26. Johnson CM. Infant and toddler sleep: a telephone survey of parents in one community. J Dev Behav Pediatr. 1991;12(2):108–14.

    Article  CAS  Google Scholar 

  27. Ragins N, Schachter J. A study of sleep behavior in two-year-old children. J Am Acad Child Adolesc Psychiatry. 1971;10(3):464–80.

    Article  CAS  Google Scholar 

  28. Durand VM. Sleep better! A guide to improving sleep for children with special needs. Baltimore: Paul Brookes Publishing Company; 1998.

    Google Scholar 

  29. Durand VM. Treating sleep terrors in children with autism. J Posit Behav Interv. 2002;4:66–72.

    Article  Google Scholar 

  30. Kuhn BR. The excuse-me drill: a behavioral protocol to promote independent sleep initiation skills and reduce bedtime problems in young children. In: Perlis M, Aloia M, Kuhn B, editors. Behavioral treatments for sleep disorders: a comprehensive primer of behavioral sleep medicine interventions. San Diego: Elsevier; 2011. p. 299–309.

    Chapter  Google Scholar 

  31. Turner KS, Johnson CR. Behavioral interventions to address sleep disturbances in children with autism spectrum disorders: a review. Topics Early Child Spec Educ. 2012;33(3):144–52.

    Article  Google Scholar 

  32. Brown CA, Kuo M, Phillips L, Berry R, Tan M. Non-pharmacological sleep interventions for youth with chronic health conditions: a critical review of the methodological quality of the evidence. Disabil Rehabil. 2013;35(15):1221–55.

    Article  Google Scholar 

  33. Meltzer LJ, Mindell JA. Systematic review and meta-analysis of behavioral interventions for pediatric insomnia. J Pediatr Psychol. 2014;39(8):932–48.

    Article  Google Scholar 

  34. Schreck KA. Behavioral treatments for sleep problems in autism: empirically supported or just universally accepted. Behav Interv. 2001;16:265–78.

    Article  Google Scholar 

  35. Didden R, Curfs LMG, Sikkema SPE, de Moor J. Functional assessment and treatment of sleeping problems with developmentally disabled children: six case studies. J Behav Ther Exp Psychiatry. 1998;29:85–97.

    Article  CAS  Google Scholar 

  36. Didden R, Sigafoos J. A review of the nature and treatment of sleep disorders in individuals with developmental disabilities. Res Dev Disabil. 2001;22:255–72.

    Article  CAS  Google Scholar 

  37. Mullane J, Corkum P. Case series: evaluation of a behavioral sleep intervention for three children with attention-deficit/ hyperactivity disorder and dyssomnia. J Atten Disord. 2006;10(2):217–27.

    Article  Google Scholar 

  38. Knight RM, Johnson CM. Using a behavioral treatment package for sleep problems in children with autism spectrum disorders. Child Fam Behav Ther. 2014;36:204–21.

    Article  Google Scholar 

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Correspondence to Valerie Paasch .

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Paasch, V., Flanders, X.C., Slifer, K.J. (2019). Behavioral Sleep Interventions. In: Accardo, J. (eds) Sleep in Children with Neurodevelopmental Disabilities. Springer, Cham. https://doi.org/10.1007/978-3-319-98414-8_28

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  • DOI: https://doi.org/10.1007/978-3-319-98414-8_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98412-4

  • Online ISBN: 978-3-319-98414-8

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