Behavioural sleep interventions for the management of non-respiratory sleep disorders in children with neurodisability

Abstract

Non-respiratory sleep disorders, including behavioural sleep disorders (e.g., difficulty with sleep onset and sleep maintenance) affect up to 80 % of children with neurodisability (ND). Non-respiratory sleep disorders in typically developing children can be treated using a variety of behavioural strategies and interventions, however generalisability of these interventions to children with ND remains uncertain. A systematic search of databases revealed 55 papers that were included in this review. Most (69 %) studies focused on children with ASD and/or ADHD with a limited number found in other disability groups. Intervention delivery mode varied with 13 % using an online format and 87 % in person, with group (44 %) and individual (52 %) approaches exhibiting similar efficacy. Results outlined key findings; 1) The breadth of ND conditions included is limited 2) small sample size across the majority of studies 3) interventions may need to be adapted to improve effectiveness 4) while mode of delivery varied, effects were similar and 5) highest intensity programs were not the most effective. Our review shows that while sleep strategies and interventions can be effective in treating non-respiratory sleep disorders in this cohort, more evidence is required to determine how best to tailor these to address challenges that are unique to children with ND.