How Does Sleep Deprivation Functionally Impact the Challenging Behavior of People With Intellectual Disabilities? A Systematic Review

Sleep deprivation is a common health condition among people with intellectual disabilities. Studies have linked sleep problems with challenging behaviors. However, it is unclear if there is a consistent effect on challenging behavior and what reinforcement mechanism(s) might be involved. A systematic review of PsychINFO, PubMed, and Scopus identified seven studies meeting the inclusion criteria that had been published over the past 50 years. Data were extracted regarding participant characteristics, specific aim, sleep deprivation, functional behavioral assessments, results, and key findings. Studies consistently reported increased rates of challenging behavior following bouts of sleep deprivation. Five of the seven studies demonstrated negative reinforcement as the mechanism associated with increased challenging behavior. Results were unclear or lacking for other reinforcer mechanisms. Current evidence shows that sleep deprivation can increase negatively reinforced challenging behavior, but automatic and positive reinforcement mechanisms may be unaffected. Theoretical and practice implications are discussed.