Children's Sleep Problems Seldom Addressed At Two Pediatric Clinics
Sleep problems tend to go undiagnosed in adults, but they were seldom addressed at two general pediatric clinics examined in another study published in Pediatrics (June 6, 2001). The project, headed by Ronald D. Chervin, MD, Director of the Michael S. Aldrich Sleep Disorders Laboratory in Ann Arbor, Mich., found that in the vast majority of cases, sleep problems in children with sleep-related symptoms seldom had their problems addressed, diagnosed, or treated.
Dr. Chervin and his colleagues identified a series of children with sleep-related symptoms and reviewed medical chart notes for the previous two years to determine how often sleep problems had been addressed. They selected children between the ages of two and 14 years of age who had clinic appointments at two university-affiliated but community-based general pediatrics clinics.
The researchers developed a survey, the Pediatric Sleep Questionnaire (PSQ), and used it to identify patients at high risk for chronic sleep-disordered breathing, periodic limb movements during sleep, insomnia, or excessive daytime sleepiness. They searched chart notes over the previous two years to identify sleep-related symptoms, diagnoses, or treatments.
Their conclusions: "Children with PSQ-identified sleep problems at 2 general pediatrics clinics seldom had these problems addressed, diagnosed, or treated, despite discussions about some aspect of their sleep in the large majority of cases. These findings," they added, "support expansion of clinician and parent education about sleep disorders in children."
Dr. Chervin noted that this was not a national sample, but both local clinics involved in the study primarily served community-based populations. Affiliation of each site with an academic medical center - which offers ready access to a large sleep center -- suggests that the study results might have been even more disturbing if a larger variety of sites been surveyed.
"My guess is the problem (of undiagnosed sleep disorders) is worse in children than in adults," said Dr. Chervin. "The relatively young field of sleep medicine has only recently realized that sleep disorders may not look the same in children as they do in adults. We are still working to get the word out to practitioners and parents."