title: Prevalence of diagnosed sleep disorders in pediatric primary care practices.
abstract: OBJECTIVE
  The primary aim was to determine the prevalence of International Classification of Diseases, Ninth Revision (ICD-9), sleep disorders diagnosed by pediatric providers in a large, primary care network. Secondary aims were to examine demographic variables related to these diagnoses and to examine the frequency of prescriptions for medications potentially used to treat sleep disorders.
  
  
  METHODS
  Electronic medical records were reviewed for 154957 patients (0-18 years) seen for a well-child visit in 2007. Information collected included ICD-9 sleep diagnoses, demographic variables, comorbid attention-deficit/hyperactivity disorder and autism spectrum disorders, provider type, and medications.
  
  
  RESULTS
  Across all ages, 3.7% of youths had an ICD-9 diagnosis for a sleep disorder. The most-common diagnoses were sleep disorder not otherwise specified, enuresis, and sleep-disordered breathing. Predictors of sleep disorders varied according to developmental age group and included growth parameters, comorbid attention-deficit/hyperactivity disorder or autism spectrum disorder, and provider type. Potential sleep-related medications were prescribed for 6.1% of the sample subjects.
  
  
  CONCLUSIONS
  This study is one of the first to examine comprehensively ICD-9 sleep diagnoses given by primary care providers in a large representative sample of children 0 to 18 years of age. The 3.7% of patients with ICD-9 sleep diagnoses is significantly lower than prevalence rates reported in epidemiological studies, which suggests that primary care providers may be underdiagnosing sleep disorders in children and adolescents. Because sleep disorders are treatable when recognized, the results from this study suggest a significant need for additional education and support for primary care providers in the diagnosis and treatment of pediatric sleep disorders.
authors.affiliation: Children's Hospital of Philadelphia, Division of Pulmonary Medicine, 3535 Market St, 14th Floor, Philadelphia, PA 19104, USA. meltzerl@email.chop.edu
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Meltzer
authors.forename: Courtney
authors.initials: C
authors.lastname: Johnson
authors.forename: Jonathan
authors.initials: J
authors.lastname: Crosette
authors.forename: Mark
authors.initials: M
authors.lastname: Ramos
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Mindell
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004775:Enuresis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011320:Primary Health Care; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000453:epidemiology*
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