1 They also detailed two novel non-pharmacological approaches based on bed materials and accessories: a weighted blanket 2 and a novel mattress technology. The researchers found that group-based training of parents in behavioural approaches to manage sleep problems may be effective, especially with regards to parent-set goals and the parent’s sense of efficacy. Parent involvement is critical in changing sleep problems in children. The researchers noted that further investigations are needed to identify factors that predict treatment success and to tailor behavioural interventions for young children based on child, parental and environmental factors and any underlying pathology. However, the choice of behavioural intervention can be guided by the preference of the parent and there is no evidence that one approach is more effective than another. Behavioural interventions that employ a gradual approach, such as gradual withdrawal, gradual extinction and fading, are favoured over making an abrupt change. In paediatric cases where the disorder is already chronic, they recommend that regardless of NDD status, good sleep practice and behavioural interventions should be the first approach. state that prevention is the best treatment for insomnia. Their key findings are discussed below.īruni et al. In their recent Practitioner Review, Oliviero Bruni and colleagues outline the non-pharmacological and pharmacological treatments currently used to treat chronic insomnia in children and adolescents with NDDs. As such, diagnosis of a sleep disturbance can be difficult, and is often exacerbated by the child’s reduced communication skills. The underlying causes for these disturbances are unclear, but may be due to another co-occurring medical condition, poor sleep hygiene or behavioural insomnia. Such disturbances include difficulties falling asleep (sleep onset latency), night awakenings and short sleep duration. Sleep disturbances affect up to 86% children with neurodevelopmental disabilities (NDDs). Such studies are urgently needed to determine the efficacy, effectiveness and safety of sleep medicines that are currently prescribed to affected children off-label. They explain that well-controlled studies that use objective polysomnography and subjective sleep measures are lacking. Earlier this year, Oliviero Bruni and colleagues compiled a Practitioner Review for the Journal of Child Psychology and Psychiatry on the pharmacologic treatment options for insomnia in children with NDDs. Insomnia is a common problem in children with neurodevelopmental disabilities (NDDs), and has a profound effect on quality-of-life.
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