Difficulty sleeping is common among those with FASD. However, sleep difficulties are seldomly discussed in the literature, or among health care professionals and caregivers, as the focus remains on challenges experienced during the day. It is widely known that sleep is important for brain development, and poor sleep has been found to have a direct effect on daytime functioning because of the impact on emotional regulation, behavioural outbursts, and learning.

How sleep effects daytime behaviours
Poor sleep may result in:

• Inattentiveness
• Hyperactivity
• Clumsiness
• Reduced empathy
• Cognitive (i.e., memory) and emotional deficits

Main findings from the study

• Caregivers described nighttime routines and preparing for sleep as challenges, but failed to acknowledge that sleep patterns are a large contributor to daytime challenges
• The night-day challenges are an important area of focus for children with FASD, but are not currently recognized or well understood by caregivers
• Poor sleep is often viewed as a general issue in children, but should be viewed as contributing to the symptoms of FASD
• Sleep may be seen as less important than other characteristics of FASD, or that there is nothing to be done about it, but recognizing that poor sleep will affect the following day is important in proper treatment

Recommendations

• Nighttime challenges should be questioned on a deeper level by caregivers
• It should be acknowledged that daytime behaviours are related to poor sleep at night
• Caregivers and health care professionals should identify poor sleep as an important factor contributing to FASD symptoms

Take-home message
Nighttime challenges are commonly identified among children with FASD, however sleep itself is not as widely seen as contributing to poor behaviours during the day. Further studies on more specific aspects of nighttime routines and sleep are important to more thoroughly understand its impact on children with FASD, and to in turn implement appropriate education and treatment for sleep challenges in this population.

Authors: Karen Spruyt, Osman Ipsiroglu, Sylvia Stockler, James N. Reynolds 

Journal: International Journal of Developmental Disabilities