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Clinician Perceptions Around Management of Sleep Problems in Children With Neurodisability
Kasey Fullwood1, Kate O'Donohue2, Anne Bernard3
1Child Health Research Centre, The University of Queensland, South Brisbane, Australia.
Insights
Clinicians managing children with neurodisability (ND) face challenges in addressing sleep disorders, often lacking training and clear pathways. National guidelines are recommended for consistent sleep management in this population.
Area of Science:
- Pediatric Medicine
- Neurology
- Sleep Science
Background:
- Children with neurodisability (ND) exhibit higher prevalence of sleep disorders compared to typically developing peers.
- Sleep issues are frequently reported by caregivers and observed by clinicians across various pediatric subspecialties.
- Understanding non-sleep specialists' perspectives on managing pediatric sleep disorders is crucial.
Purpose of the Study:
- To explore the perceptions of diverse pediatric clinicians regarding their role in assessing and managing sleep disorders in children with ND.
- To identify challenges and barriers faced by non-sleep specialists in pediatric sleep management.
Main Methods:
- Cross-sectional survey distributed to clinicians across multiple specialty disciplines (excluding sleep medicine) in three Australian tertiary pediatric hospitals.
- Survey included multiple-choice questions, free-text responses, and case studies.
- Quantitative descriptive statistics and qualitative thematic analysis were employed for data analysis.
Main Results:
- 80% of surveyed clinicians recognized sleep problems as significant in children with ND, with families frequently raising concerns.
- Clinicians predominantly used informal screening methods (70%), with limited utilization of validated tools.
- Confidence in managing sleep disorders varied by specialty, though medical specialists reported higher confidence; lack of training and unclear referral pathways were identified as key barriers.
Conclusions:
- Non-sleep specialized clinicians encounter significant challenges in managing sleep disorders in children with neurodisability.
- Findings underscore the need for developing national clinical guidelines to standardize and improve sleep management approaches for this vulnerable population.
Introduction:
Children with neurodisability (ND) experience higher rates of sleep disorders when compared to typically developing children. Children with ND frequently receive care from multiple medical services; sleep problems are commonly mentioned by caregivers and encountered by clinicians across various disciplines. However, the perspectives of these clinicians on managing sleep in this cohort of children are not widely understood. This study aimed to explore how clinicians from diverse paediatric fields perceive their role in the assessment and management of sleep disorders in children with ND.
Method:
A cross-sectional survey involving clinicians across multiple specialty disciplines (excluding sleep medicine) from three tertiary paediatric hospitals in Australia was conducted. The survey included multiple choice questions, free text responses and case studies. Data analysis included quantitative (descriptive) statistics and thematic analysis of free text responses.
Results:
Ninety-five clinicians participated. Of these, 80% of clinicians (n = 77) identified sleep as a significant issue in this population, with sleep problems regularly raised by families within routine consults. Clinicians reported predominantly (70%) relying on informal methods to screen for sleep, with limited use of validated screening tools. Confidence in managing sleep varied across specialties and sleep disorder presentations, with medical specialists generally confident across all sleep presentations. Clinicians reported offering treatment advice to families, while simultaneously reporting limited training and confidence. A lack of training, unclear referral pathways and time constraints were described as barriers for management.
Conclusion:
Non-sleep specialised clinicians describe challenges when managing sleep in children with neurodisability. Findings support the development of national clinical guidelines to provide a more consistent approach to sleep management.
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