O044 Behaviour Sleep Interventions for the management of non-respiratory sleep issues in Children with Neurodisability

Abstract Introduction Non-respiratory sleep issues affect 80% of children with neurodisability (ND) compared to 40% of typically developing children, resulting in reduced sleep and daytime dysfunction. Despite various behavioural interventions evaluated with varying success, there’s still a lack of clear evidence on the most effective approach to managing sleep in this population. This review aims to provide a comprehensive overview of existing sleep interventions for children with ND and their effectiveness to inform future development. Method This review adhered to Cochrane Library guidelines, encompassing studies of children and young people aged 2-18 years diagnosed with Neurodevelopmental Disorders (ND) and experiencing non-respiratory sleep issues as per DSM-5-TR or ICD criteria. A search across five databases and two trial registries was conducted, followed by screening for duplicates and eligibility, with data extraction and critical appraisal of included papers. Results 55 papers were included. The majority of studies (69%) focused on children with ASD and/or ADHD, indicating a significant under-representation of other neurodisabilities. Some studies made adaptations to their interventions, primarily involving changes in language, visual examples, and increased repetition. The comparison of delivery format (online vs. in-person, group vs. individual) showed no significant difference. Higher intensity interventions demonstrated lower effectiveness. Sustained effects were observed for the first 3-6 months before diminishing. Discussion Most interventions led to some improvement in sleep issues, with a similar structure observed across programs. While this review identifies various sleep strategies and programs to address sleep problems, it highlights the necessity for higher quality randomized controlled trials (RCTs) to determine the most effective strategies. Conclusion This review offers one of the most extensive summaries of evidence regarding behavioural interventions for improving sleep in children with neurodisabilities.