OAARSN Book Review


Sleep Better! A Guide to Improving Sleep for Children with Special Needs
by V. Mark Durand (1998). Paul H. Brookes Publishing Co., Baltimore,
282 pages. Includes appendices, bibliographic references, index.

ISBN 1-55766-315-7 paperback.

"Unless you have experienced it yourself, it is almost impossible to describe the feeling in the pit of your stomach when you hear your child cry at 12:30 A.M.-- one more night of hundreds of such nights. Just as your body and your mind have begun to give up the tensions of the day, the stirring followed by the inevitable crying jolt you into the dreaded realization that it is happening one more time. One more night that your child will have disrupted sleep and, despite your feeling guilty about thinking this way, you are aware that you too will not get a full and complete night's rest -- by now a luxury for which you would be willing to trade much" (p.xiii).

Dr Durand is a psychology professor who came to write this book because of his personal experience with his son's multiple problems with sleep. As he embarked, more than 20 years ago, on work with children who have special needs, he was alarmed to find that that they are much more likely to have sleep difficulties than children in general. His work and this book express empathy with the high stress and chronic anxiety of parents whose children have special needs.

People with autism may be among the most seriously affected by sleep problems, almost all of them experiencing difficulties at some stage in their lives. For many, sleep problems persist into adulthood. Problems with sleep can be a sign of other problems, the chronic anxiety of people with autism being one. Disturbed sleep, when persistent, has a negative effect on performance and behavior and will probably mean that a person is mistakenly considered of low ability, especially if they also do not speak. Sleep problems also affect emotional well-being and may lead to or worsen self-injurious and aggressive behavior. A child's sleep difficulties can threaten the parents' marriage, mental health and livelihood.

Sleep Better!ís text is organized in three parts. The first, The Nature and Problems of Sleep, includes overviews of sleep and sleep problems. The second, Assessing Sleep Problems, includes steps to understanding, a sleep diary, behavior log, sleep interview (with details of specific disorders and their possible causes and effects). The greater part of the book, Strategies for Change, consists of chapters on: good sleep habits; help for bedtime problems (includes two autism case studies); sleeping through the night; sleeping at the wrong times; nightmares and sleep terrors; excessive sleepiness and movement-related sleep problems (relevant to autism); other nighttime difficulties (such as bedwetting, anxiety, depression, headaches, teeth-grinding); daytime behavior problems; sleep and medications (not recommended as a long-term solution); and preventing sleep problems.

The appendices present information about support groups and associations, sleep pages on the World Wide Web (none include specific reference to autism), and accredited sleep disorders centers (with a warning that many centers do not accept people with autism or mental retardation), as well as details of a sleep diary and behavior log and of the Albany Sleep Problems Scale.

The good news is that the procedures recommended in Sleep Better! could well help both children and their parents to sleep better, even within a few weeks. Many of the strategies could also be adapted to help teenagers and adults with sleep problems.