Nonpharmacological Sleep Interventions for Children With Angelman Syndrome: A Scoping Review

Sleep is a fundamental occupation that supports children's health and learning and family well-being. Children with Angelman syndrome (AS) experience some of the most severe and persistent sleep disturbances of any neurogenetic disorder, highlighting an underexplored need for nonpharmacological, occupation-centered interventions.

To identify and synthesize current knowledge on nonpharmacological sleep interventions for children with AS, describe intervention strategies and reported outcomes, and outline implications for occupational therapy practice.

We searched Web of Science, APA PsycINFO, PubMed, and CINAHL from inception through September 1, 2025, and reviewed AS foundation websites for gray literature.

We included studies of nonpharmacological sleep interventions with children with AS. The first author screened titles and abstracts; two reviewers independently screened full texts and charted data using Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidance.

Three studies were synthesized: one randomized controlled trial, one single-case experimental design, and one case report. Interventions were primarily behavioral or caregiver mediated; one involved a short-term sedative adjunct in a behavioral program. Collectively, these studies demonstrated improvements in sleep initiation, duration, and continuity, and caregivers reported reduced stress and high satisfaction with feasibility.

Behavioral and caregiver-mediated sleep strategies consistently improved children's ability to fall asleep and remain asleep while supporting family functioning. Findings suggest that sleep is a modifiable occupation and highlight opportunities for occupational therapy practitioners to adapt and deliver family-centered interventions that establish healthy sleep routines and supportive environments. Plain-Language Summary: Angelman syndrome (AS) is a rare neurodevelopmental condition that often causes severe sleep difficulties among children. Our scoping review looked at strategies to improve sleep for children with AS without using medication and considered their relevance to occupational therapy practice. We identified three studies, and the results were encouraging. The most effective approaches involved establishing consistent bedtime routines, gradually adjusting sleep schedules, and coaching parents to manage sleep behaviors. When these strategies were used, children with AS fell asleep faster, slept longer through the night, and woke up less often. Parents reported less stress and greater confidence in managing their child's sleep. These nondrug methods are practical for families to use at home and align with occupational therapy's focus on daily routines, the environment, and family well-being. Occupational therapy practitioners can guide caregivers to create structured, calming bedtime routines that promote better sleep, participation, and overall quality of life. Positionality Statement: Joseph Barrett is a parent of a child with Angelman syndrome, which informed the motivation for this study but not its examination or interpretation. Shelly J. Lane is a professor in the Department of Occupational Therapy at Colorado State University. Throughout the review, we maintained reflexivity and transparency to support objectivity and methodological rigor. To minimize bias, we used predefined eligibility and data-charting templates, conducted calibration for full-text screening, and resolved discrepancies through consensus.