Related Experiment Video
Updated: Sep 21, 2025
Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD — A Safe, Cost-Effective Approach
Published on: October 18, 2024
Rates of diagnoses of sleep disorders in children with chronic medical conditions
Pranshu A Adavadkar1,2, Andrea A Pappalardo1,2, Anne Elizabeth Glassgow1
1Department of Pediatrics, University of Illinois Children's Hospital, University of Illinois at Chicago, Chicago, Illinois.
Insights
Sleep disorder diagnoses are underrecognized in children with chronic medical conditions, particularly ethnic minorities. Early screening and management are crucial for better health outcomes in this vulnerable population.
Area of Science:
- Pediatric Health
- Sleep Medicine
- Chronic Illness Management
Background:
- Sleep disorders (SDs) are common but underdiagnosed in children with chronic medical conditions (CMCs).
- Limited data exists on SD prevalence and diagnostic patterns within this specific pediatric population.
- Understanding these patterns is vital for improving care and health outcomes.
Purpose of the Study:
- To investigate the rates of sleep disorder diagnoses in a large cohort of children and adolescents with CMCs.
- To examine how SD diagnoses vary by CMC type, demographics, and number of CMCs.
- To identify potential underdiagnosis of SDs in this high-risk group.
Main Methods:
- Utilized Medicaid claims data from the Coordinated Health Care for Complex Kids (CHECK) project.
- Analyzed data from 16,609 children and adolescents (0-18 years) with at least one CMC.
- Diagnoses of SDs and CMCs were extracted from claims data.
Main Results:
- 14% of the study population received an SD diagnosis, most commonly sleep-disordered breathing (11.2%).
- SD diagnoses were significantly higher in children with multiple CMCs (19.7%) compared to those with single CMCs (5.8%).
- Insomnia rates were lower in Hispanic/Latinx and African American children compared to Caucasians.
Conclusions:
- Medicaid claims data reveals potential underdiagnosis of SDs in children with CMCs, especially in ethnic minority populations.
- Underrecognition of SDs can lead to adverse short- and long-term health and economic consequences.
- Findings support the need for enhanced SD screening and management protocols for pediatric patients with CMCs.
Study Objectives:
This investigation examines sleep disorder (SD) diagnoses in a large population of children and adolescents with chronic medical conditions (CMCs). Little is known about SD diagnoses in this population. The large population used in this study allowed examination of SD rates by CMC type and demographics.
Methods:
Data were from the Coordinated Health Care for Complex Kids (CHECK) project designed for Medicaid-funded children and adolescents with at least 1 CMC from a large metropolitan area. The study population (n = 16,609) was limited to children and adolescents, 0 to 18 years of age. SD and CMC diagnoses were obtained from Medicaid claims data.
Results:
Fourteen percent of the population (mean age of 9.1 years [standard deviation = 5.2]; 35.8% African American; 56.4% male; 77 with more than 1 CMC) received a sleep disorder diagnosis. The most frequent diagnosis was sleep-disordered breathing (11.2%), followed by nocturnal enuresis (1.2%) and insomnia (1%). SDs were diagnosed more frequently in those with multiple CMCs than in those with 1 CMC (19.7% vs 5.8%; P < .001). Insomnia rates in Hispanic/Latinx (1.2%) and African American (0.8%) children and adolescents were significantly lower (both P < .001) than in Caucasians (3.5%). Odds of receiving a sleep diagnosis varied among CMCs.
Conclusions:
Our analysis of Medicaid claims data of a large urban cohort offers detailed information about the rates of sleep diagnoses and suggests underdiagnosis of SDs in this vulnerable, high-risk, primarily ethnic minority population. Underrecognition of sleep disorders has short- and long-term health and economic consequences. Study results may help clinicians implement appropriate SD screening and management for children and adolescents with CMCs.
Citation:
Adavadkar PA, Pappalardo AA, Glassgow AE, et al. Rates of diagnoses of sleep disorders in children with chronic medical conditions. J Clin Sleep Med. 2022;18(8):2001-2007.
Related Concept Videos
01:18Nightmares and Night Terrors
Nightmares...
01:07Narcolepsy
01:24Sleep-Wake Cycles
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:17Other Pulmonary Disorders
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...