Description
Previous research indicated a high prevalence of disordered sleep among adults with intellectual disabilities, however issues with study design impacted findings. The prevalence of disordered sleep among adults with intellectual disabilities has recently been identified as ranging from 6.1-74.2%. Few of these studies monitored sleep using objectives measures. Additionally, the prevalence of sleep disorders varies significantly when considering the underlying cause of a patient’s intellectual disability. The diagnosis of insomnia requires a “complaint” which can often be missing or presents differently in the intellectual disability population. As a result, insomnia is not regularly diagnosed. Sleep disorders in adults with intellectual disability needs to incorporate objective measures alongside a way of considering how it impairs social, occupational, educational, behavioural, or other important areas of functioning. In primary care, it was noted that the proportion of people with intellectual disabilities treated with psychotropic drugs exceeded the proportion with recorded mental illness and antipsychotics are prescribed for people with no recorded severe mental illness but behaviours that challenge. Public Health England reported that up to 35000 people with ID a day take psychotropic medications they may not need. Our session will provide an overview of the prevalence of disordered sleep and sleep disorders amongst adults with intellectual disability. We will present the prevalence of different sleep parameters (such as short sleep duration). We will summarise the prevalence of sleep disorders and disordered sleep according to cause of intellectual disability. Following a mixed methods concurrent design study, we will present the results of 27 research participants with intellectual disabilities who have worn an actigraphy watch whilst tracking their behaviours that challenge. The data was analysed using multi-level modelling to understand the relationship between sleep and behaviours that challenge. The qualitative arm of the study included 16 people, ten with intellectual disabilities, and six of their carers and relatives. The study will provide a way of defining the impact of disordered sleep. Afterwards, a national strategy to rationalise psychotropic medications in the intellectual disability population will be described, including how it can be implemented safely and successfully. During our session, we will provide participants with strategies for assessment and intervention when people with intellectual disability present with disordered sleep or sleep disorders in the community. This will include, how different causes of intellectual disability may increase the likelihood of sleep disorders, such as obstructive sleep apnoea in adults with Down syndrome. We will help participants to consider how to measure sleep and its impact. Finally, we will provide ways to embed STOMP into clinical practice.
Format
Recorded webinar.
This content was recorded during the APA 2023 Annual Meeting.
Learning Objectives
- Understand the prevalence of disordered sleep and sleep disorders that present in adults with intellectual disabilities.
- Describe what disordered sleep among adults with intellectual disabilities means and its implications for practice.
- Provide types of circadian rhythm sleep wake disorders that present in adults with intellectual disability.
- Understand how STOMP (a national project to reduce psychotropic prescribing in adults with intellectual disability) can improve patient quality of life through collaboration and innovation.
- Identify factors that increase the likelihood of STOMP being implemented safely in your service.
Target Audience
Residents/Fellows, Psychiatrists, Psychologists
Estimate Time to Complete
Estimated Duration: 1.25 hours
Program Start Date: May 1, 2025
Program End Date: May 1, 2028
How to Earn Credit
Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.
Continuing Education Credit
In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The APA designates this live activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Instructors
- Paul Shanahan, MD
- Aruna Sahni
- Rupal Ekeberg
Planners
- Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.
Accessibility for Participants with Disabilities
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Technical Requirements
This internet-based CME activity is best experienced using any of the following:
- The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
- Internet Explorer 11+
This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
- Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
- Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
- Internet Connection: 1 Mbps or higher
Minimum Requirements:
- Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
- Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance