Sleep Problems in Young People with a Learning Disability
Sleep is the natural state of bodily rest observed in humans and animals. Regular sleep is often understood as a process of restoration needed for our survival.
Sleep problems are particularly common in children and adolescents with learning disabilities and these problems tend to fall into one of three categories:
- Difficulty getting to sleep or staying asleep.
- Sleeping too much.
- Disturbed episodes that interfere with sleep.
Factors which are thought to affect sleep include physical and psychological factors. Examples of physical factors include breathing problems, epilepsy, and physical discomfort at night. Examples of psychological factors include anxiety, low mood, and over-activity (e.g. ADHD).
Sleep problems in children and young people with learning disabilities tend to impact upon the whole family and can often affect all family members’ wellbeing. In addition, sleep problems can have various effects on the young person themselves. For example, the young person may experience daytime sleepiness resulting in an impaired performance at school. The young person may also experience irritability and behavioural problems due to sleep deprivation.
Thankfully, sleep problems in children and young people are treatable with appropriate and well-considered approaches.
Principles of sleep hygiene for children and adolescents
ENVIRONMENT CONDUCIVE TO SLEEP
Correct temperature (many children wake in the night because they are either too hot or too cold).
Darkened, quiet room.
No negative associations (e.g. punishment).
- Introduce a pleasant bedtime routine; which could be something like "wash, change, then bedtime story".
- Visual timetables can be used to indicate each part of the bedtime routine; they ensure consistency, familiarity and can aid the child’s understanding.
- Consistent bedtime and waking-up times.
THINGS TO ENCOURAGE
- Going to bed only when tired.
- Thinking about problems and plans before bedtime. For anxious children it can be useful to talk through any concerns and plans for the next day, to help alleviate any worries about this.
- Falling asleep without parents.
- Regular daily exercise.
THINGS TO AVOID
- Excessive or late napping during the day.
- Overexcitement near bedtime.
- Late evening exercise.
- Caffeine-containing drinks late in the day.
What treatments are available?
Behavioural treatments are commonly used successfully for treating children with learning disabilities. These require a specialist to observe the child over a period of time to help identify possible causes. It is also important for the specialist to talk with parents in order to develop a greater insight into the child’s sleep problems.
Possible interventions could be:
For children who struggle to settle – work on conditions that encourage sleep (e.g. a bedtime routine, relaxation skills).
For children who struggle to settle without parents – parents gradually increase the physical distance between themselves and the child at bedtime.
For children who find it difficult to stay in their own bed – positively reward the child with something they like (e.g. watch a film, praise) for staying in bed during the night.
Some children may benefit from medication, such as hypnotics or melatonin. A qualified Psychiatrist or Paediatrician would be able to provide you with more information.
When to consider asking for more specialist help
CONSIDER SEEKING HELP:
- You are unable to cope with your child’s sleep problem.
Your child is having difficulties due to their sleep problem (e.g. struggling at school).
Your child’s sleep problem is affecting their quality of life.
Please talk to your Paediatrician, Social Worker, or School about a referral to the LD-CAMHS team.
Further support, advice and self-help
Sleep Council is an organisation that offers advice on how you can adopt healthier sleep habits and focuses on raising awareness of a good night’s sleep to improve our health and wellbeing.
The National Autistic Society provides information and support for people with Autism and their families and for professionals. They are a very active organisation and offer some really useful information about strategies and approaches for supporting people with Autism.
The British Institute of Learning Disabilities also have some useful information and further advice about a variety of common issues.
Local Offer is a Derbyshire-specific site which allows you to search for lots of different services, including parenting support groups, in the local area.