Abstract
Sleep is vital for our physical and mental health. Studies have shown that there is a high prevalence of sleep disorders and sleep difficulties amongst adults with intellectual disabilities. Despite this, sleep is often overlooked or its disorders are considered to be difficult to treat in adults with intellectual disabilities. There is a significant amount of research and guidance on management of sleep disorders in the general population. However, the evidence base for sleep disorders in adults with intellectual disabilities is limited. In this review paper, we look at the current evidence base for sleep disorders in adults with an intellectual disability, discuss collaborative working between intellectual disabilities psychiatrists and sleep medicine specialists to manage sleep disorders, and provide recommendations for future directions.
Highlights
Sleep is vital for our physical and mental health
We look at the current evidence base for sleep disorders in adults with an intellectual disability, discuss collaborative working between intellectual disabilities psychiatrists and sleep medicine specialists to manage sleep disorders, and provide recommendations for future directions
Sleep disorders, including sleep-disordered breathing and insomnia, are more common in adults with intellectual disabilities when compared with the general population,[1] with one systematic review finding that 32% of individuals with intellectual disabilities experienced multiple sleep problems.[2]
Summary
Anchoring the day Setting a fixed rising time that is maintained 7 days a week, no matter how tired the individual is or how little they have slept. Sleep diaries completed by carers and/or actigraphy, ideally undertaken for a minimum of 2 weeks, can be used when sleep–wake timings (including napping) are inconsistent or unreliable.[39] Home or in-patient sleep investigations (for example, pulse oximetry or the gold-standard, polysomnography) can be used to investigate physical sleep disorders such as OSA and nocturnal epilepsy in people with intellectual disabilities.[40] While these investigations should always be offered when clinically appropriate, a pragmatic trial of treatment may sometimes be required when sleep investigations are not tolerated by the individual. The pharmacological management of non-insomnia disorders tend to follow the same pathways as those for the general population.[31]
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