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Measuring sleep with the actiwatch in clients with severe and multiple disabilities

This study examines the prevalence of sleeping problems in clients with severe and multiple disabilities, explores possible causes, and provides recommendations at the client and organizational level. The study utilizes Actiwatch measures of physical activity, light intensity, and sleeping patterns.

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Measuring sleep with the actiwatch in clients with severe and multiple disabilities

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  1. Measuring sleep with the actiwatch in clients with severe and multiple disabilities Renske Koordeman, Researcher Marieke Fokkink, Behavioral scientist Stefanie Cerneus, Physician intellectual disabilities

  2. Introduction Prevalencesleepingproblems: • General population 15-25% • ID adults 40-67% • ID children > 80% Sleepingproblem: • Difficultieswithfalling a sleep • Oftenawakeduring the night • Awakeveryearly (Didden, 2008; Didden, Korzilius, van Aperlo, van Overloop, & de Vries, 2002; Didden & Sigafoos, 2001; Didden, Smits, & Curfs, 2004; Maas et al., 2008; Maas et al., 2009; Maas, Didden, Korzilius, & Curfs, 2012; Maas et al., 2010; Tietze et al., 2012).

  3. Sleeping problems related to behavioral problems • Stereotypicalbehaviour • Hyperactivity • Aggression • Lessmotivation • Lessactivity • Automutilation (Brelewskiand Wiggs,1999; Didden et al., 2002; Chen, Spano, & Edgin, 2013; Symons et al., 2000; van der Wouw, 2013)

  4. Sleeping problems related to behavioral problems ADHD Of the childrendiagnosedwith ADHD, 25% actually has a sleepingproblem (Chervin, 1997)

  5. Chicken or egg? Difficult: Causes Consequences Co morbidity ???

  6. Causes and consequences relation Causes: • Epilepsy- viciouscircle • Sleep apnea • Nightmares Consequences: • Decrease in cognitivefunctioning • Increase in ASS and ADHD symptoms • Irritation/aggression • Heartproblems • Overweight (Didden andTrentelman, 2002)

  7. Normal sleep cycle

  8. Aims study • Investigate: • Prevalence sleeping problems in clients with severe and mutiple disabilities • Possible causes • Give recommandations at client level and organisational level

  9. Method Design: Pre and post test T0 Intervention T1 T0 and T1: • Client wearesActiwatchfor 14 days • Sleepingdiaryfor 14 days • Questionnaire dailyfunctioningandmedicalproblems

  10. Actiwatch Measures: • Physicalactivity • Light intensity • Sleepingpatterns

  11. Example client • 20-year oldmale clientwith severe intellectualdisabilityandepilepsy • Summer 2015: • Since 1,5 yearverytired • Inactive/red eyes • Multiple napsduring the day • Increase in absences andfallincidents

  12. T0

  13. Actions Outcomes: • Actiwatch: average of 11h en 45min in bed during the night • Average 1 h during the day in bed • Max 14 hours in bed per day Actions • Bed times: 9.00 pmto7.00 am • Max of 45 min in bed during the day

  14. T1 Effects: • Lesstired • No sleepingduring the day • Fit andhappier • Lessepilepsy

  15. Questions?

  16. Slaapprobleem • Primair slaapprobleem: • Inslaapproblemen • Mild = in slaap vallen duurt 30 min. < 1uur, 1 of 2 keer per week. • Ernstig = in slaap vallen duurt > 1uur, 3 of meer keer per week • Doorslaapproblemen • Mild = wakker worden in de nacht 1 of 2 keer per week, langer dan 15 min. wakker blijven. • Ernstig = wakker worden in de nacht (meer dan) 3 keer per week, cliënt blijft langer dan 15 min. wakker blijven. • Vroeg wakker worden • Mild = Voor 5 uur wakker worden 1 of 2 keer per week. • Ernstig = Voor 5 uur wakker worden (meer dan) 3 keer per week. • Secundair slaapprobleem: In de klinische praktijk spreken we alleen van een slaapprobleem als het functioneren van de cliënt overdag (negatief) wordt beïnvloed door een primair slaapprobleem.

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