It's not just adults whose sleep problems often go undiagnosed: Children also are at risk for undiagnosed sleep problems. A recent study points to a partial explanation for this: Very few pediatricians are trained in sleep issues, and many do not feel confident in making diagnoses related to sleep.
Using a questionnaire that was distributed to 700 pediatricians, all of whom were members of the American Academy of Pediatrics, the study evaluated the screening practices that pediatricians use to identify possible sleep problems in children. The study also looked at how knowledgeable pediatricians are about sleep problems that are common to children, and whether they received any formal training in sleep during their medical education.
The results are troubling news for the many parents of children who struggle with disrupted sleep. Despite a widespread belief among pediatricians that sleep issues are important to children's health, many of the doctors surveyed showed a lack of basic knowledge about sleep issues, and few had received any specific training in sleep medicine.
Researchers reported that:
• 96 percent of pediatricians believe it is their job to provide treatment guidance on issues related to sleep and sleep problems
• Only 18 percent of those surveyed had received formal training related to sleep and sleep disorders
• Fewer than one in six pediatricians reported feeling confident in their abilities to provide guidance to parents about their children's sleep
The pediatricians surveyed also appear to have gaps in their knowledge about the sleep issues that can affect children. When asked a series of questions about specific sleep disorders:
• Only 13 percent were able to answer questions about snoring correctly
• Only 13 percent responded correctly to questions about sleep apnea
• Only 29 percent had correct answers to questions about bed wetting
• Only 8 percent answered questions about narcolepsy correctly
Formal sleep training appeared to make a measurable difference in pediatricians' ability to incorporate sleep into treatment. Among the minority of pediatricians who had received training in sleep issues, these doctors demonstrated a greater knowledge of sleep disorders, reported higher levels of confidence in providing counseling and diagnosis of sleep problems and were more likely to screen for sleep problems in their patients.
Another troubling result? Only 12 percent of pediatricians believed that parents would bring up their children's sleep issues at a doctor's visit. This lack of confidence unfortunately speaks volumes about the overall lack of communication about kids' sleep between parents and pediatricians.
For children, the consequences of undiagnosed sleep problems can be serious. Complications to their mental and physical health that arise from poor sleep can start early and last well into adulthood. Children with sleep disorders face greater risks of:
• Cardiovascular problems, including high blood pressure
• Mental health issues
• Behavior problems and developmental issues
Sleep disorders, including insomnia and sleep apnea, are not just sleep issues for adults. Kids can suffer from these problems as well, with similar effects on short-term daily functioning and on long-term health. Parents, it's important that you pay attention to your child's sleep habits, and be prepared to spot the signs of disrupted sleep. In children, some signs are easier to identify than others, and sleep issues do change as children age and develop. Here are some red flags to watch for:
• Trouble falling asleep
• Waking often throughout the night
• Tiredness first thing in the morning
• Mood changes
• Lack of focus at school or around the house
If you have concerns about your child's sleep habits, bring them to your pediatrician. Work with your child's doctor to help make -- and keep -- sleep a priority, and a regular part of the conversation at your child's check up.
In order for our doctors -- pediatricians and others -- to provide effective guidance and treatment for our sleep problems, they must be trained and educated. We know most physicians believe sleep is a critical aspect of health: it's time that their professional education gives them the tools they need to treat sleep seriously, and well.
Michael J. Breus, PhD
The Sleep Doctor™
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