Sleep Health in Adults with Intellectual Disability: Recent Advances and Persistent Evidence Gaps

Topic: Risk, prevention and care in population studies

Abstract Purpose of Review Adults with intellectual disability (ID) experience a disproportionate burden of sleep disorders with major impacts on physical, neuropsychiatric and behavioural health, yet evidence to guide practice has lagged behind the general population. This review updates our 2024 narrative synthesis, focusing on clinically actionable advances in sleep health for adults with ID. Recent Findings Recent observational data in adults with Down syndrome indicate that obstructive sleep apnoea is associated with adverse cardiometabolic, mortality and Alzheimer disease outcomes. Positive airway pressure can be feasible with individualised support, while retrospective studies of surgical treatment suggest possible benefits in selected patients, although residual OSA and confounding by treatment selection remain important considerations. Emerging diagnostic technologies, including home-based acoustic sensors, wearables, cardiorespiratory algorithms and three-dimensional facial biomarkers, represent promising developments that require further evaluation against established diagnostic pathways. Meta-analytic and cohort studies describe aetiology-related sleep phenotypes and persistent sleep and circadian disruption in autistic adults; a small uncontrolled case series provides preliminary evidence that daridorexant may be tolerated and associated with improved sleep in selected adults with intellectual disability. Summary Despite recent advances, major inequalities persist, highlighting the need for accessible diagnostics, population‑specific instruments and adult‑focused guidelines embedding sleep management within lifelong care for people with ID.

Key findings

• Recent Findings Recent observational data in adults with Down syndrome indicate that obstructive sleep apnoea is associated with adverse cardiometabolic, mortality and Alzheimer disease outcomes.
• Meta-analytic and cohort studies describe aetiology-related sleep phenotypes and persistent sleep and circadian disruption in autistic adults; a small uncontrolled case series provides preliminary evidence that daridorexant may be tolerated and associated with improved sleep in selected adults with intellectual disability.

Why it matters

This review reports that in adults with Down syndrome, obstructive sleep apnoea is associated with adverse Alzheimer disease outcomes, and that treatments such as positive airway pressure and surgery have been studied with limitations. It is a review of observational and retrospective data and does not establish that treating sleep apnoea prevents or cures Alzheimer's disease.

Study details

• Study designcohort study
• Evidence strengthModerate

Read the original

• DOI: 10.1007/s11940-026-00892-8
• Original source →
• Free full text: Current Treatment Options in Neurology →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{sirinimnualkul2026-0b24ddbe,
  author  = {Sirinimnualkul, Naphat and Perera, Bhathika and O'Regan, David John},
  title   = {{Sleep Health in Adults with Intellectual Disability: Recent Advances and Persistent Evidence Gaps}},
  journal = {Current Treatment Options in Neurology},
  year    = {2026},
  doi     = {10.1007/s11940-026-00892-8},
  url     = {https://doi.org/10.1007/s11940-026-00892-8}
}

Studies this one cites

Referenced by this study and also in the alzhub library, so you can read them here.

• Circadian Rest-Activity Rhythms, Cognition, and Alzheimer Disease Dementia in Adults With Down Syndrome Neurology · 2026-05-07 · usefulness score 56/100 · Down syndrome and Alzheimer's
• The Occurrence of Obstructive Sleep Apnea and Its Association With Alzheimer Dementia in Medicaid-Enrolled Adults With Down Syndrome, 2011-2019 American journal of medical genetics. Part A · 2025-09-03 · usefulness score 44/100 · Down syndrome and Alzheimer's

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• Prevalence of dementia and impact on intellectual disability services Mental retardation · 2000-06-01 · usefulness score 38/100
• A pilot study of the reliability and validity of the Caregiver Activity Survey - Intellectual Disability (CAS-ID) Journal of intellectual disability research : JIDR · 2002-11-01 · usefulness score 34/100
• Epilepsy and subsequent dementia in adults with down syndrome: a propensity score-matched cohort study using federated electronic health records Seizure · 2026-08-28 · usefulness score 53/100
• Health care concerns and guidelines for adults with Down syndrome American journal of medical genetics · 1999-06-01 · usefulness score 41/100
• Functional connectivity differences in the default mode and frontoparietal networks in older adults with Down syndrome are related to obstructive sleep apnea Alzheimer s & Dementia · 2025-12-01 · usefulness score 36/100

Also tagged “down”

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• Cognitive functions in adult Down's syndrome The International journal of neuroscience · 1990-10-01 · usefulness score 35/100 · Down syndrome and Alzheimer's
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• A review that covers this ground Down syndrome--recent progress and future prospects Human molecular genetics · 2009-04-01 · usefulness score 40/100
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