Although pediatric sleep concerns are very common (an estimated 25% of children experience a sleep problem at some point), they tend to be under-diagnosed in the primary care setting. This may be partly because parents don’t always bring up sleep disturbances during visits, particularly beyond the infant and toddler years.
While all children and adolescents should be regularly screened for sleep issues, it is particularly important in a child who:
- has difficulty concentrating
- is experiencing a decline in academic performance
- has behavior problems
- has concerns about mood or anxiety
When a potential sleep issue is identified, a thorough history should include detailed questions about potential symptoms of sleep-disordered breathing (e.g. snoring, breathing pauses, restless sleep, sweating during sleep) as well as its risk factors (e.g. allergies, asthma, positive family history, gastroesophageal reflux).
Clinicians should also assess daytime sleepiness, insomnia, and sleep practices (including the child's sleep schedule, bedtime routine, electronic media use), and the family's previous attempts at addressing the sleep problems (what did and did not work).
Clinician resources for evaluating sleep problems
Sleep issues can require a lot of clinician time to investigate and resolve, often beyond the time available for a well child visit. Here are some resources to help you screen for and evaluate sleep problems in your patients:
- The "BEARS" screening tool targets the key questions to include in screening for sleep problems during well child visits.
- The parent-report Children's Sleep Habits Questionnaire for preschoolers and elementary school-aged children.
- The self-report Sleep Survey Report can help ascertain a school-aged child's sleep habits.
- There are also clinically useful questionnaires for older children/adolescents in both parent-report and self-report forms.
- The American Academy of Sleep Medicine recently released its recommendations for sleep amounts in children of different ages.
- The Pediatric Hypersomnolence Survey is survey to screen sleepy children ages 8 to 17 years for narcolepsy and idiopathic hypersomnia.
Referrals and inquiries
Primary-care pediatricians sometimes contact us to ask if a referral to the Sleep Center is appropriate for certain patients.
We are always happy to see new patients regardless of the extent of their sleep disturbance. We evaluate the full range of sleep problems in children and adolescents — from simple sleep apnea to behavioral insomnia, from narcolepsy and circadian rhythm disorders, to complex breathing disorders and sleep disruption in children with special needs.
In short, there is no problem too small or too complex for us to evaluate and manage.
Our subspecialty clinical services related to sleep include:
- sleep coaching
- narcolepsy clinic
- behavioral sleep services such as cognitive behavioral therapy for insomnia (CBT-I)
- multidisciplinary pulmonary/dental/ORL care for children with complex sleep-disordered breathing
- specialized dentistry services
Our sleep specialists can answer any questions you may have about referring a patient or getting a second opinion on a sleep issue.