Sleep: Evidence Base

Neurodiversity Hub Wirral

Evidence Base: Why Sleep Matters

Sleep is one of the most important parts of mental health and emotional well-being. Many studies show that poor sleep increases the risk of mental health and developmental challenges (Freeman et al., 2017; Martin et al., 2019; Ravyts & Dzierzewski, 2020). 

It’s not just about how much sleep someone gets—it’s about the quality of sleep. Good sleep means: 

  • Falling asleep within 10–20 minutes 

  • Staying asleep without waking often 

  • Falling back asleep quickly if woken 

Poor sleep quality is common in people with neurodevelopmental conditions. If sleep improves, some behaviours may also improve. This can show that sleep problems were part of the issue

What Helps Improve Sleep Quality?

Here are some tips backed by research: 

  • Get natural light during the day (Campbell, Dawson, & Anderson, 1993; Sanassi, 2014) 

  • Avoid blue light at night from screens like phones and TVs (Higuchi et al., 2005) 

  • Keep a regular sleep schedule, even on weekends (Van Dongen & Dinges, 2003; Giannotti et al., 2002) 

  • Keep the bedroom cool—between 19–24°C is ideal (Caddick et al., 2018) 

  • Avoid eating late at night (Vander Wal, 2012) 

If these tips don’t help, and sleep problems continue, speak with a General Practitioner (GP) or healthcare professional. You can also keep a sleep diary for 2+ weeks to track patterns

  • What to Include in a Sleep Diary 

    You can find a sleep diary template by searching “sleep diary NHS.” It usually asks: 

    • What time did you go to bed? 

    • How long did it take to fall asleep? 

    • What time did you wake up? 

    • What time did you get out of bed? 

    • How long were you awake during the night? 

    • How many times did you wake up? 

    • Rate your sleep quality from 1–5 

     

    Sleep and Neurodevelopmental Conditions 

    Some neurodevelopmental conditions, like: 

    • Attention Deficit Hyperactivity Disorder (ADHD) 

    • Autism Spectrum Disorder (ASD) 

    …can include sleep problems. 

    Children with ADHD may have: 

    • Sleep-disordered breathing 

    • Restless legs syndrome (Konofal & Lecendreux, 2010; Tsai, Hsu, & Huang, 2016) 

    Children with ASD may struggle with: 

    • Rigid bedtime routines 

    • Sensory overload 

    • Anxiety and racing thoughts (Cohen et al., 2014; Cortesi et al., 2010) 

    Sleep strategies can help most people, but some children may need tailored support based on their needs

  • Research Spotlight: Melatonin Use 

    📰 The Lancet, July 2023 
    Study title: Use of melatonin for children and adolescents with chronic insomnia attributable to disorders beyond indication 
    Authors: Henriette Edemann-Callesen et al. 

    What the Study Found 

    • Melatonin may help children and teens with sleep problems linked to conditions other than Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). 

    • It may reduce the time it takes to fall asleep by about 15 minutes and increase total sleep time by 19 minutes. 

    • These changes did not improve daytime functioning or sleep quality. 

    • Side effects were not well studied. 

    What This Means 

    Melatonin should only be used: 

    • With advice from a medical specialist 

    • When sleep hygiene and non-medication strategies haven’t worked 

    • In children aged 2–20 years with chronic insomnia caused by other conditions 

    🔗 Read the full study in The Lancet00226-2/fulltext