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Individual and socio-demographic factors related to presenting problem and diagnostic impressions at a pediatric
Sonia L Rubens1, Kristina E Patrick2, Ariel A Williamson3
1Psychology Department, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA 70148, United States.
Insights
Socio-demographic factors influence pediatric sleep clinic visits. Racial and ethnic minority children may be underserved, despite higher sleep disturbance risks.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychology
- Public Health
Background:
- Individual and socio-demographic factors are linked to childhood sleep disturbances.
- Research on these factors in children attending specialized sleep clinics is limited.
Purpose of the Study:
- To investigate individual and socio-demographic factors associated with presenting problems and diagnoses in new patients at a pediatric sleep clinic.
Main Methods:
- Electronic medical records of 207 pediatric patients were analyzed.
- Patient data included age, gender, race, and presenting sleep concerns.
- Diagnostic impressions were also recorded for analysis.
Main Results:
- Older children, females, and White children were more likely to report difficulty falling asleep.
- Younger children, males, and Black children were more likely to present with obstructive sleep apnea (OSA) concerns.
- Older age correlated with diagnoses like insomnia and circadian rhythm disorders, while younger age was linked to provisional OSA and behavioral insomnia of childhood (BIC).
Conclusions:
- Findings align with existing literature on pediatric sleep disorder prevalence.
- Race was associated with presenting concerns and BIC, with one link to neighborhood disadvantage.
- A potential service gap exists, as racial/ethnic minority youth may be less likely to access sleep services despite higher risks.
Objective:
Individual and socio-demographic factors have been found to be associated with sleep disturbances in children. Few studies have examined these factors among children presenting for care at pediatric sleep clinics. This study examined individual and socio-demographic factors in association with presenting problems and diagnostic impressions for new patients at an interdisciplinary pediatric sleep clinic.
Methods:
Data were collected from electronic medical records of 207 consecutive patients (54% male, 59% White, Meanage = 7.73, SD = 5.62).
Results:
Older age, female gender, and White race were associated with higher likelihood of presenting with difficulty falling asleep; younger age, male gender, and Black race were associated with higher likelihood of presenting with obstructive sleep apnea (OSA)-related concerns. Older age was associated with diagnostic impressions of inadequate sleep hygiene, insufficient sleep, circadian rhythm disorder/delayed sleep phase disorder, periodic limb movement disorder/restless legs syndrome, and insomnia, while younger age was associated with provisional OSA and behavioral insomnia of childhood (BIC) diagnoses. Male gender was associated with provisional OSA. White race was associated with BIC. Age-based analyses were also conducted to further understand the findings within a developmental context.
Conclusions:
Age- and gender-related findings converged with prevalence literature on pediatric sleep disorders. Race was only associated with presenting concern and BIC, and one association for neighborhood disadvantage was found within the age-based analysis. Results suggest a potential service delivery gap, with racial/ethnic minority youth being less likely to present for sleep services, despite prevalence data on the increased likelihood of sleep disturbances among these youth.
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