Multifactorial Influences, Including Comorbidities, Contributing to Sleep Disturbance in Children with a Neurodevelopmental Disorder.

The term neurodevelopmental disorder (NDD) implies an impairment of the growth and development of the CNS caused by genetic, metabolic, toxic, or traumatic factors. Childhood neuropsychiatric disorder is a subset of NDD. Sleep disturbance is reported in many children with NDD although the details of this association, including extent and types of sleep disturbance, etiology, and assessment and treatment issues, need to be clarified by further research.

Commentary: Thinking outside the box about children's sleep--a commentary on Gregory and Sadeh (2016).

This commentary is intended to supplement the accompanying review of sleep problems in childhood psychiatric disorders by Gregory and Sadeh. A number of considerations are outlined because of their relevance to both clinical practice and research concerning assessment and treatment of sleep disturbance in children in general and especially those with psychiatric and/or neurological conditions. These considerations (which illustrate the importance of combined medical and psychological involvement) are as follows: the importance of screening for sleep disturbance which otherwise may well be overlooked; the need to specify sleep disorders rather than simply nonspecific sleep problems as this will guide choice of appropriate advice and treatment; the risk of sleep disorders being misdiagnosed because of clinicians' unfamiliarity with the sleep disorders field; the possibility that a child's sleep disturbance is of multiple aetiology; a wide range of treatments for disturbed sleep is now described from which a choice is possible given an accurate diagnosis; sleep problems may be intensified if a child's condition is complicated by intellectual disability but the same principles of assessment and management apply as in other children in the expectation that treatment can be effective.

Review: psychiatric and medical consequences of disordered sleep.

Objectives: The aim of this article is to draw attention to the clinical importance of disordered sleep in psychiatry and to demonstrate the growing awareness of medical illness as a complication of disordered sleep. As background to these main objectives, some general points are made to illustrate present-day approaches to the common and often serious problem of sleep disturbance.

Methods: The review is based on a literature search from which key publications were selected to illustrate, in turn, main connections between disordered sleep and psychiatric and medical conditions.