This site is intended for health professionals only

Improving sleep for adults with learning disabilities and other complex needs

Improving sleep for adults with learning disabilities and other complex needs
With permission: Sleep Scotland

Training as a sleep counsellor could be helpful when supporting adults with sleep problems, suggests Martyna Jabłońsk at Sleep Scotland

Adults with learning disabilities and other complex needs face a range of sleep issues that can profoundly impact their overall quality of life. As nurses, it is necessary to understand the role that sleep plays in their lives and to be equipped with strategies and techniques to help improve their sleep.

Adults with intellectual and developmental disabilities often experience sleep problems due to physical conditions, sensory sensitivities, emotional or behavioural difficulties, or the side effects of medication. This provides a considerable challenge as poor sleep has a compounding knock-on effect. Poor sleep impacts an individual’s quality of life, which can exacerbate health or behavioural issues, further degrading their quality of sleep.

Sleep is a complex process that plays a critical role in physical and mental health. During sleep, the body recovers and repairs itself. While sleeping, the brain consolidates the day’s memories and balances hormones that regulate bodily processes such as the immune system and metabolism. Sleep also plays a crucial role in mental and emotional wellbeing, such as healthy sleep mood regulation and stress and anxiety reduction. All of which can improve focus and problem-solving skills and enhance creativity.

The average adult needs between 7 and 9 hours of uninterrupted sleep. Fewer hours than this or disrupted sleep can lead to irritability and impaired judgement and impact communication skills. Sleep deprivation can even lead to an increased risk of obesity and chronic diseases, including diabetes and heart disease.

Poor sleep can be particularly detrimental to the physical health of adults with additional needs who may already face increased health risks. Chronic sleep deprivation can exacerbate physical conditions like chronic pain and muscle weakness while increasing the risk of secondary health problems, resulting in decreased mobility and physical independence and affecting daily activities and quality of life.

Mental health is also seriously affected by sleep deprivation. Individuals already struggling with emotional regulation and social functioning can experience increased feelings of anxiety and depression as a result of poor-quality sleep.

This can intensify symptoms of conditions such as ADHD and autism spectrum disorder and can lead to feelings of frustration and social isolation.

Problems sleeping can even contribute to behavioural issues, which can be challenging to manage, like aggression and self-injury, and in some cases, lead to an increased risk to the individual and others.

Tips for improving sleep for adults with complex needs

As a nurse, you play an important role in helping individuals with complex needs improve their sleep.

Here are some practical tips to get started:

  1. Establish a regular sleep routine: Regular sleep and wake times, even during weekends, help to set the body’s internal clock and regulate the release of hormones at the correct times. Encouraging physical activity and exposure to natural light during the day and limiting screen time and large meals close to bedtime can also improve sleep quality.
  2. Create a sleep-friendly environment: Ensure the individual’s bedroom is conducive to sleep. Keep the space minimal and comfortable by removing clutter and reducing light and noise levels. Maintaining a comfortable temperature of 16-18 degrees Celsius should also be a priority, as our bodies expect a natural temperature drop as we fall asleep.
  3. Encourage relaxation techniques: Teaching relaxation techniques, such as deep breathing, progressive muscle relaxation, and visualisation will help individuals relax, unwind and fall asleep more easily.
  4. Promote a healthy lifestyle: Encourage the individual to adopt healthy habits, such as regular exercise, a balanced diet, and avoiding stimulants such as caffeine after 2 pm, to improve their sleep.
  5. Find a motivator: Healthy sleep has incredible benefits, but when working with adults with additional needs, it is important to set real-world goals that can be achieved as a result of engaging with these techniques as motivation. Exhaustion may prevent an individual from engaging in social and academic life, or occupation, so encouraging a regular sleep routine in this context can improve their engagement and result in improved sleep.
  6. Rally support: Progress can be slow, which can be difficult for individuals with learning disabilities. Engaging with individuals who are sleep-deprived can be difficult, as their capacity to take on anything new is limited. This means support from family, carers, and other professionals is critical to the success of their sleep management programme.
  7. Consistency is key: Any improvement in an individual’s quality or quantity of sleep, however small, can make a huge difference in their quality of life, but improving sleep does not happen overnight. When working with adults with complex needs, continuous and consistent engagement over an extended period is critical in improving sleep.

By following these tips and working closely with the individual and their healthcare team, you can help them to achieve better sleep and improve their overall health and wellbeing.

It may also be helpful to work with non-profits such as Sleep Scotland, to become a trained sleep counsellor and provide effective personalised sleep interventions.

Sleep Scotland’s training course, Sleep Counselling for Adults, delivers the knowledge and skills necessary to support and promote healthy sleep in adults with complex needs, by applying cognitive and behavioural approaches in tailored interventions for a range of sleep issues.

Martyna Jabłońska is head of sleep services at Sleep Scotland.


See how our symptom tool can help you make better sense of patient presentations
Click here to search a symptom