The need for interdisciplinary pediatric sleep clinics.
The purpose of this study was to describe the function and structure of an interdisciplinary outpatient pediatric sleep clinic. In addition, the frequency of individual and comorbid sleep diagnoses, the prevalence of comorbid medical or psychiatric disorders, and the types of treatment recommendations and referrals provided to patients at the end of their clinic visits was examined. Over a 4-month period, 265 consecutive patients were evaluated in the sleep clinic by trainees, nurses, and attendings in pulmonary medicine, neurology, and psychology. Obstructive sleep apnea was the most common diagnosis, followed by behavioral insomnia of childhood. Over half of the patients had a comorbid medical diagnosis, and 31% had a comorbid psychiatric diagnosis. Polysomnography was the most common recommendation, with 38% of patients receiving at least one behavioral recommendation. The results of this descriptive study support the need for an interdisciplinary approach to pediatric sleep medicine, providing broad training to trainees of all disciplines while improving the clinical care for children with sleep problems.
Division of Pulmonary Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. meltzerl@email.chop.edu
Lisa J
LJ
Meltzer
Melisa
M
Moore
Jodi A
JA
Mindell
D000293:Adolescent; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003299:Cooperative Behavior; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007318:Inservice Training; D033183:Interdisciplinary Communication; D008297:Male; D010348:Patient Care Team; D010414:Pennsylvania; D012017:Referral and Consultation; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*