Sleep disorders in children/adolescents with neurodevelopmental and neurological disorders: what evidences do we have with the use of non-pharmacological interventions?
Abstract
Background: Sleep disturbances are highly prevalent across neurological and neurodevelopmental disorders (NDDs) and often exacerbate core symptoms, impair daytime functioning, and increase caregiver burden. Despite frequent clinical use of behavioral and educational strategies, the evidence base for non-pharmacological sleep interventions in this population remains scarce.
Data source: This narrative review aimed to analyze behavioral interventions that can be used for sleep problems in children and adolescents with NDDs, and synthesizes data from recent studies that examined those non-pharmacological interventions in epilepsy, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), cerebral palsy (CP), and rare genetic neurodevelopmental conditions (RGNCs).
Results: Across NDDs, insomnia symptoms are highly prevalent, with circadian disturbances and sleep-disordered breathing also common in some groups. Behavioral and parent-led interventions-including psychoeducation, sleep hygiene, structured routines, and extinction-based strategies-consistently improve parent-reported sleep and often enhance daytime behavior, though objective sleep gains are smaller. In epilepsy and ASD, tailored behavioral-educational programmes are both effective and acceptable. In ADHD, behavioral sleep interventions and melatonin improve sleep, with behavioral approaches also yielding modest reductions in ADHD symptoms. Evidence for CP and RGNCs is limited but supports…
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