Sleep problems and sleep disorders in pediatric primary care: treatment recommendations, persistence, and health care utilization

Abstract

Study objective: This study examined documented treatment recommendations provided for sleep disorders and sleep problems in pediatric primary care, the persistence of sleep problems and sleep disorders in children and adolescents, and the relationship between sleep issues and health care utilization.

Methods: In-depth chart review of pediatric primary care patient visits (n = 750 patients) from 2007 through 2010.

Results: Only 26 children (5.2% of those with a sleep disorder/ problem) received a treatment recommendation, with half of these recommendations behavioral in nature. Sleep disorders and sleep problems were highly persistent across time for up to a third of children. Children with sleep disorders had significantly more sick visits/calls (mean = 8.84, 95% CI 7.77-9.90) than children without a sleep disorder (mean = 6.34, 95% CI 5.56-7.12).

Conclusions: Very few children or adolescents were found to have documented treatment recommendations or referrals for diagnosed sleep disorders or sleep problems. In addition, given that sleep disorders and sleep problems are highly persistent, as well as result in more sick visits/calls, it is important that pediatric primary care providers screen for and identify these issues across development. Furthermore, it is essential to provide health care providers with more education and support on sleep disorders and sleep problems in pediatric primary care.

Keywords: Child; adolescent; pediatrician; sleep issue.

Figures

Figure 1

(A) Percent of children with a sleep disorder documented at follow-up visits for children with sleep disorder, sleep problem, and no sleep issue at baseline visit. (B) Percent of children with a sleep problem documented at follow-up visits for children with sleep disorder, sleep problem, and no sleep issue at baseline visit.