Both insomnia and excessive sleepiness occur in individuals with intellectual disabilities. While insomnia often raises concern, excessive sleep is rarely associated with a sleep disorder. However, sleep disorders can impact daily functioning, leading to behavioral problems, mood fluctuations, and affecting overall physical and mental well-being. In children with intellectual disabilities, poor sleep quality can further disrupt growth and development.
Sleep problems are common in individuals with intellectual disabilities but are often unrecognized. Many individuals cannot verbally express their sleep difficulties, and the more severe the intellectual disability, the greater the communication barrier. Additionally, caregivers—both at home and in professional care settings—often lack awareness of sleep disorders in this population.
The Center for Sleep Medicine at Kempenhaeghe has specialized expertise and facilities to assess the connection between intellectual disabilities, sleep problems, and co-occurring conditions (including epilepsy). We provide multidisciplinary and personalized care, addressing both the medical and behavioral aspects of sleep disorders.
Medical specialists, intellectual disability physicians (AVG), nursing home physicians, and general practitioners can refer patients to the Center for Sleep Medicine. This includes individuals living in institutions, at home, or in supported independent living settings.
Relationship with Epilepsy
The brain of individuals with intellectual disabilities exhibits different brain wave patterns compared to those of individuals without disabilities. The more severe the intellectual disability, the harder it becomes to distinguish between different sleep phases in brain wave activity.
Additionally, many individuals with intellectual disabilities also have epilepsy. Epileptic seizures can be related to sleep quality and complicate the analysis of sleep recordings in this group.
At Kempenhaeghe, specialists are trained in interpreting EEG recordings, breathing patterns, heart rate measurements, and (eye) movements in individuals with intellectual disabilities. The treatment team includes medical specialists, psychologists, and behavioral therapists as a minimum standard of care.
First Steps Toward Better Sleep
Additionally, at Kempenhaeghe’s Center for Epilepsy Residential Care, we have years of daily practical experience in providing tailored care and support for adults and children with intellectual disabilities and epilepsy.
In many cases, sleep problems in individuals with intellectual disabilities are linked to how their daily life is structured in their living and daytime activity environment. Providing advice on day and night rhythms, adjustments to daily routines, and sometimes even changes in the living situation can be important first steps toward better sleep.
Sleep-related breathing disorders in individuals with intellectual disabilities
Individuals with intellectual disabilities may suffer from obstructive sleep apnea (OSA). The Center for Sleep Medicine provides specialized care for this group, including adapted sensors and diagnostic methods.
Treatment, such as CPAP therapy, is tailored to their specific needs, often requiring intensive support. Short-term hospital stays may be used to provide personalized care, with parents or caregivers closely involved in the treatment process.
If CPAP therapy is not feasible, alternative options such as positional training or a mandibular repositioning appliance (MRA) may be considered.
Neurological sleep disorders in individuals with intellectual disabilities
- Central hypersomnia: Patients may experience narcolepsy or idiopathic hypersomnia, often presenting as excessive daytime sleepiness. Diagnosis and treatment require adapted methods, such as polysomnography with specialized sensors and multidisciplinary support.
- Restless Legs Syndrome (RLS): In individuals with intellectual disabilities, RLS can lead to sleep problems, such as insomnia or restlessness. Treatment is tailored to the patient’s needs, as evidence for this population is limited. The approach may include medication and behavioral support.
- Parasomnias: Abnormal behaviors during sleep, such as sleepwalking or nightmares. Diagnosis is conducted using polysomnography with video recordings, and treatment is often multidisciplinary and personalized.
Chronic insomnia in individuals with intellectual disabilities
Chronic insomnia often occurs alongside other behavioral problems in individuals with intellectual disabilities. The Center for Sleep Medicine offers specialized Cognitive Behavioral Therapy for Insomnia (CBT-I). This treatment involves intensive support for both the patient and their caregivers to effectively address sleep problems.
Behavioral insomnia in individuals with intellectual disabilities
In individuals with intellectual disabilities, sleep problems may be caused or worsened by behavioral factors. The Center for Sleep Medicine provides tailored guidance to address and resolve these sleep issues, with specific attention to the care and support required by individuals with intellectual disabilities.
