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Exploring Sleep Challenges and Interventions in Children with a Vision Impairment: A Scoping Review
Emma Oakes1, Laura N Cushley1, Tunde Peto1
1Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, UK.
Insights
Sleep problems are common in children with vision impairment. Melatonin shows short-term benefits, but more research on non-pharmacological interventions is needed for effective, sustainable options.
Area of Science:
- Pediatric Sleep Medicine
- Ophthalmology
- Evidence Synthesis
Background:
- Sleep disturbances are prevalent in children with vision impairment.
- These issues can impede physical, emotional, and cognitive development.
- Effective interventions require identification and evaluation.
Purpose of the Study:
- To map sleep challenges in children with vision impairment.
- To summarize evaluated interventions for these sleep problems.
Main Methods:
- Systematic literature searches in Embase, Medline, and Web of Science.
- Screening, data extraction, and descriptive analysis.
- Narrative synthesis of findings from 15 included studies.
Main Results:
- Most studies (14/15) were from high-income countries.
- Common sleep issues include delayed sleep onset and fragmented sleep.
- Melatonin was the most studied intervention, showing short-term effectiveness.
Conclusions:
- The current evidence base is limited and heterogeneous.
- Non-pharmacological interventions require further research and testing.
- More comparative studies are needed for sustainable treatment options.
Abstract:
Background/Objectives: Sleep problems are highly prevalent among children with vision impairment and can negatively affect physical, emotional, and cognitive development. There is a need to identify and evaluate effective interventions in this population. This scoping review aimed to map the range of sleep challenges experienced by these children and to summarise the interventions evaluated to date. Methods: Systematic searches were performed in Embase, Medline, and Web of Science Core Collection. Screening was completed in Covidence, and data extraction and descriptive analysis were conducted using Microsoft Excel (version 2510) and IBM SPSS Statistics (version 30). Narrative synthesis was used to summarise findings. Results: Fifteen studies were included, over half of which were case reports. The vast majority (14/15) were conducted in high-income countries, leaving a significant evidence gap for low- and middle-income settings. Reported sleep challenges included delayed sleep onset, non-24-h sleep-wake disorder, early morning waking, and fragmented sleep. Interventions were predominantly pharmacological (11/15), with melatonin the most frequently evaluated. Across studies, melatonin demonstrated short-term effectiveness in improving sleep latency, duration, and parent-reported quality, though prescribing practices, dosages, and availability varied. Other pharmacological options, such as tasimelteon and vitamin B12, were rarely reported. Non-pharmacological strategies were evaluated in only a small number of studies and included behavioural interventions, structured routines, and activity-based therapies. These showed potential benefit but remain under-researched. Conclusions: Overall, the evidence base is small, heterogeneous, and methodologically limited. Further research is needed to develop and carefully test non-pharmacological approaches, and to compare them directly with pharmacological treatments, to provide families and clinicians with effective and sustainable options.
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