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Sleep Problems in Children with Developmental Disabilities

austistic and down syndrome child sitting in bed

Nearly half of children ages 2 to 5 years with autism spectrum disorder (ASD) or a neurodevelopmental disorder (NDD) with some autistic features have significant sleep difficulties (AAP, 2019). Sleep difficulties can exacerbate social communication deficits in children with ASD, increase characteristic repetitive and restrictive behaviors and contribute to aggression and self-injury behaviors.

Sleep problems do not differ from those experienced by children in the general population, but a child with ASD or NDD may experience multiple forms of sleep disruption. In addition, a greater number of factors may contribute to the problems within the child and family. Note that sleep problems, however, “can be treated in ways that do not, in most cases, require extraordinary medical intervention” (AAP, 2019).

Screening for sleep problems in all young children can enable early and appropriate interventions. Multiple interventions for children with NDD for different aspects of sleep include:

  • Creating successful bedtime routines
  • Minimizing night waking
  • Avoiding middle-of-the-night bed sharing

In addition, health-care providers may need to simultaneously address relevant gastrointestinal or respiratory issues.

Be Aware of Cultural and Racial/Ethnic Differences in Sleep Routines

Recognizing differences among various cultural and racial/ethnic groups can help providers assess a child’s sleep patterns and provide guidance that is relevant to parents. Two recent systematic reviews of sleep habits provide insight into some common differences in bedtime, nocturnal sleep duration, napping and total sleep duration among infants and preschool-aged children, including:

  • Children from Europe, North America and Australasia were more likely to have an earlier bedtime, earlier wake-up time and longer nocturnal sleep duration than children from Asia and the Middle East region.
  • Infants in Asia were more likely to have longer and more frequent naps, and parents in Asia were more likely to report nocturnal awakening, bedtime resistance and general sleep problems than parents in Europe, North America and Australasia.
  • In the U.S., white, non-Hispanic children were more likely to have an earlier bedtime, longer nocturnal sleep and fewer naps than most racial and ethnic minorities.
  • Black and Latino children in the U.S. were more likely to nap during the day, resulting in roughly equivalent total sleep duration among racial and ethnic groups.

Sources: International Journal of Environmental Research and Public Health (2021) and Sleep Health (2019)