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Non‐pharmacological interventions for non‐respiratory sleep disturbance in children with neurodisabilities: a systematic review

Lookup NU author(s): Dr Arabella Scantlebury, Gemma Spiers



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


AimTo describe existing evidence on non‐pharmacological interventions to manage sleep disturbance in children with neurodisabilities. MethodWe systematically reviewed non‐pharmacological interventions aimed at improving non‐respiratory sleep disturbance in children with neurodisability. Sixteen databases, grey literature, and reference lists of included papers were searched up to February 2017. Two researchers (B.B., C.M., G.S., A.S., A.P.) undertook screening, data extraction, and quality appraisal. ResultsTwenty‐five studies were included: 11 randomized controlled trials and 14 before‐and‐after studies. All studies were at high or unclear risk of bias. Parent‐directed interventions were categorized as comprehensive tailored interventions (n=9), comprehensive non‐tailored interventions (n=8), and non‐comprehensive interventions (n=2). Six ‘other’ non‐pharmacological interventions were included. Seventy‐one child and parent sleep‐related outcomes were measured across the included studies. We report the two most commonly measured outcomes: the Child Sleep Habits Questionnaire and sleep onset latency. Five studies reported significant improvements on at least one of these outcomes. InterpretationVarious types of non‐pharmacological intervention for managing sleep disturbance have been evaluated. Clinical heterogeneity and poor study quality meant we could not draw definitive conclusions on the effectiveness of these interventions. Current clinical guidance recommends parent‐directed interventions as the first approach to managing sleep disturbance; prioritizing research in this area is recommended.

Publication metadata

Author(s): Scantlebury A, McDaid C, Dawson V, Elphick H, Fairhurst C, Hewitt C, Parker A, Spiers G, Thomas M, Wright K, Beresford B

Publication type: Article

Publication status: Published

Journal: Developmental Medicine and Child Neurology

Year: 2018

Volume: 60

Issue: 11

Pages: 1076-1092

Print publication date: 01/11/2018

Online publication date: 29/07/2018

Acceptance date: 04/06/2018

Date deposited: 30/07/2018

ISSN (print): 0012-1622

ISSN (electronic): 1469-8749

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/dmcn.13972


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