Determinants of sleep problems in children with intellectual disability

Abstract

Many children with an intellectual disability experience problems with initiating and maintaining sleep, daytime somnolence and sleep disordered breathing (Heussler & Hiscock, 2018;Pavlova & Latreille, 2019;Surtees, 2018). While these sleep problems are also common in typically developing children, (Pavlova & Latreille, 2019), they mainly occur during early childhood (Fricke-Oerkermann et al., 2007) and can usually be managed with parental interventions such as setting a regular bedtime and limiting screen time before bed (Heussler & Hiscock, 2018). For children with an intellectual disability, sleep problems can be more severe, persist across their lifespan and while good sleep hygiene and medications can help, such interventions often do not solve the problem (Boban, 2018;Richdale, 2014).Insufficient and disrupted sleep can have negative impacts on a child's physical and mental health, as well as influencing behaviour, social competence, and learning (Foley & Weinraub, 2017;Meijer et al., 2000). The prevalence and type of sleep problems a child displays can be influenced by co-occurring comorbidities, and the type of sleep problems can vary between specific disorders (Valicenti-McDermott et al., 2019). For example, more than 50%

Negative impact of insomnia and daytime sleepiness on quality of life in individuals with the cyclin‐dependent kinase‐like 5 deficiency disorder

“…In our second multivariate model, we additionally adjusted for prescribed sleep medications. We previously reported that use of sleep medications was associated with persistently high effect sizes for the risk of insomnia and sleepiness in children with autism spectrum disorder, cerebral palsy, Rett syndrome and Down syndrome (Gilbertson et al, 2021), as we have also observed in an international sample of children and adults with Rett syndrome (Boban et al, 2018).…”

“…Model coefficients a with 95% confidence intervals (CIs) describing the association between insomnia, sleepiness, and quality of life Down syndrome (34.8%) but similar to those with autism spectrum disorder or cerebral palsy and intellectual disability and Rett syndrome (Gilbertson et al, 2021). We confirm that risk of insomnia is a transdiagnostic features of neurodevelopmental disorders (Barone et al, 2019;Heussler & Hiscock, 2018;Kamara & Beauchaine, 2020), including CDD.…”

“…Sleep problems for individuals with intellectual disability can be more severe and persistent across their lifespan (Richdale & Baker, 2014 ; Wong et al, 2015 ). Using the Sleep Disturbance Scale for Children (Bruni et al, 1996 ), a recent study of 447 children with Down syndrome, Rett syndrome, cerebral palsy or autism and comorbid intellectual disability found that nearly half (47.7%) had abnormal insomnia scores and nearly a quarter (23.3%) had excessive daytime sleepiness scores (Gilbertson et al, 2021 ). Sleep disturbances also occurs commonly in CDD, identified by nearly 90% of 141 caregivers with a child with CDD aged 4 months to 29 years and who were registered with the International CDKL5 Disorder Database (ICDD) (Mangatt et al, 2016 ).…”

Molecular Organization and Patterning of the Medulla Oblongata in Health and Disease

“…Next to syndromes with a genetic cause that are already known to be involved in development of the medulla, there are several neurodevelopmental disorders that show symptoms related to medullary function (e.g., sleep-wake cycle, breathing regulation) [ 120 ], but the genetic cause of has not clearly been linked to medullary development.…”

“…Children with trisomy 21 (Down’s syndrome) have been reported to suffer from insomnia and sleep breathing disorder [ 120 , 130 ], which is thought to be related to a more unstable ventilatory control [ 131 ]. It has been found that children with Down’s syndrome also display a smaller pons and medulla than age-matched controls [ 132 ].…”