Examples of associated sleep disorders in paediatric neurodisability clinical practice
| Condition | Non-respiratory sleep disorders | Respiratory sleep disorders | Screening/investigation |
| Autism spectrum disorder | Behavioural insomnia Bruxism Rhythmic sleep-related movement disorder such as headbanging and body rocking Circadian rhythm disturbance/desynchronisation Restless legs syndrome | Obstructive sleep apnoea (OSA) | Sleep diary±actigraphy for behavioural sleep difficulties Ferritin for restlessness Respiratory polygraphy for OSA |
| Cerebral palsy | Behavioural insomnia Bruxism Hypersomnolence due to significant sleep fragmentation (Consider medical causes that may be contributing to sleep fragmentation such as epilepsy, reflux, joint pain, respiratory compromise) | OSA Central hypopnea-apnoea syndrome Hypoventilation | Sleep diary±actigraphy for behavioural sleep difficulties Respiratory polygraphy for OSA; central events and hypoventilation |
| Down syndrome | Behavioural insomnia Bruxism Rhythmic sleep-related movement disorder such as headbanging and body rocking | OSA— patient may not necessarily snore
Hypoventilation | Sleep diary±actigraphy for behavioural sleep difficulties Polysomnography (PSG) if available or respiratory polygraphy with capnography Oximetry and capnography as alternative |
| Prader-Willi syndrome | Behavioural insomnia Hypersomnolence Rapid eye movement (REM) intrusion phenomena | OSA Central hypopnea-apnoea syndrome Hypoventilation | Sleep diary±actigraphy for behavioural sleep difficulties Respiratory polygraphy with capnography— pre-treatment and every 6 months while on Growth Hormone PSG/multiple sleep latency test (MSLT) if hypersomnolence and REM intrusion phenomena Oximetry and capnography |
| Angelman syndrome | Behavioural insomnia Non-24-hour sleep cycle | Sleep diary±actigraphy for behavioural sleep difficulties | |
| Rett syndrome | Behavioural insomnia | OSA Central hypopnea-apnoea syndrome | Sleep diary±actigraphy for behavioural sleep difficulties Respiratory polygraphy with capnography |
| Smith-Magenis syndrome | Behavioural insomnia Circadian rhythm disorder including inverse circadian rhythm | Sleep diary±actigraphy for behavioural sleep difficulties | |
| Muscular dystrophy | Hypoventilation OSA | Respiratory polygraphy and capnography | |
| Achondroplasia | OSA Central hypopnea-apnoea syndrome which may be associated with foramen magnum compression | Respiratory polygraphy and capnography | |
| Septic optic dysplasia and visual impairment | Behavioural insomnia Circadian rhythm disturbance | Sleep diary Actigraphy | |
| Williams syndrome | Behavioural insomnia Periodic limb movements syndrome (PLMS) | Sleep diary Actigraphy Polysomnography if suspected PLMS |