Review of strategies for treating sleep problems in persons with severe orprofound mental retardation or multiple handicaps

During the last 15 years, researchers have shown that a large percentage of persons with severe or profound mental retardation or multiple handicaps h ave serious sleep problems. These problems can cause emotional and physical burdens for caretakers, interfere with the persons' daily learning and occ upational performance, and/or exacerbate deviant behaviors. Several studies have been conducted to assess behavioral and pharmacological strategies (e .g., bedtime fading and response cost, extinction, chronotherapy, and the u se of melatonin) for reducing sleep problems. Those studies are reviewed he re and the effectiveness, suitability, practicality, and acceptability of t he strategies are discussed. Relevant issues for future research are also e xamined.