[Sleep disturbance in patients with developmental disability]

Many patients with developmental disabilities exhibit various types of sleep disturbance. However, we have no idea of a specific approach to relieve the symptoms on sleep disturbance, although recent basic neuroscience has provided many novel findings on the neuronal mechanisms of the sleep-wakefulness cycle. In this brief review, a flip-flop circuit was introduced to explain neuronal mechanisms of the abrupt change between sleep and wakefulness. The rate of atonia during non-REM sleep was also introduced, as this index may useful for assessing the cholinoaminergic balance of the central nervous system. Sleep hygiene was also based on basic sleep-wakefulness mechanisms. To maintain sleep hygiene is a fundamental approach caring for patients with sleep disturbance, and specific approaches such as medication and treatment of sleep disordered breathing should also be based on the basic mechanisms of the sleep-wakefulness cycle. It was emphasized that effective intervention should only occur after the careful assessment of neuronal background of each patient.