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Non-pharmacological sleep interventions for youth with chronic health conditions : a critical review of the methodological quality of the evidence

DISABIL REHABIL , 2013, vol. 35, n° 14-15, p. 1221-1255
Doc n°: 165755
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.3109/09638288.2012.723788
Descripteurs : AD72 - TROUBLES DU SOMMEIL

Restorative sleep is clearly linked with well-being in youth with
chronic health conditions. This review addresses the methodological quality of
non-pharmacological sleep intervention (NPSI) research for youth with chronic
health conditions. METHOD: The Guidelines for Critical Review (GCR) and the
Effective Public Health Practice Project Quality Assessment Tool (EPHPP) were
used in the review. RESULTS: The search yielded 31 behavioural and 10
non-behavioural NPSI for review. Most studies had less than 10 participants.
Autism spectrum disorders, attention deficit/hyperactivity disorders, down
syndrome, intellectual disabilities, and visual impairments were the conditions
that most studies focused upon. The global EPHPP scores indicated most reviewed
studies were of weak quality. Only 7 studies were rated as moderate, none were
strong. Studies rated as weak quality frequently had recruitment issues;
non-blinded participants/parents and/or researchers; and used outcome measures
without sound psychometric properties. CONCLUSIONS: Little conclusive evidence
exists for NPSIs in this population. However, NPSIs are widely used and these
preliminary studies demonstrate promising outcomes. There have not been any
published reports of negative outcomes that would preclude application of the
different NPSIs on a case-by-case basis guided by clinical judgement. These
findings support the need for more rigorous, applied research. IMPLICATIONS FOR
REHABILITATION: * Methodological Quality of Sleep Research * Disordered sleep
(DS) in youth with chronic health conditions is pervasive and is important to
rehabilitation therapists because DS contributes to significant functional
problems across psychological, physical and emotional domains. * Rehabilitation
therapists and other healthcare providers receive little education about
disordered sleep and are largely unaware of the range of assessment and
non-pharmacological intervention strategies that exist. An evidence-based website
of pediatric sleep resources can be found at http://www.SleepRight.ualberta.ca *
The current research on non-pharmacological sleep interventions (NPSI) for youth
with health conditions is methodologically weak. However, consistently positive
outcomes reported in the literature demonstrate that pragmatic interventions such
as bright light therapy, activity, massage and behavioral interventions are
promising areas. No studies found reasons that a trail of a NPSI matched to the
youth's context and condition should not attempted. More rigorous clinically
relevant study of pragmatic non-pharmacological interventions appropriate for
therapists' and parents' needs is required.

Langue : ANGLAIS

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