title: Sleep problems and sleep disorders in pediatric primary care: treatment recommendations, persistence, and health care utilization.
abstract: OBJECTIVE
  This study examined documented treatment recommendations provided for sleep disorders and sleep problems in pediatric primary care, the persistence of sleep problems and sleep disorders in children and adolescents, and the relationship between sleep issues and health care utilization.
  
  
  METHODS
  In-depth chart review of pediatric primary care patient visits (n = 750 patients) from 2007 through 2010.
  
  
  RESULTS
  Only 26 children (5.2% of those with a sleep disorder/ problem) received a treatment recommendation, with half of these recommendations behavioral in nature. Sleep disorders and sleep problems were highly persistent across time for up to a third of children. Children with sleep disorders had significantly more sick visits/calls (mean = 8.84, 95% CI 7.77-9.90) than children without a sleep disorder (mean = 6.34, 95% CI 5.56-7.12).
  
  
  CONCLUSIONS
  Very few children or adolescents were found to have documented treatment recommendations or referrals for diagnosed sleep disorders or sleep problems. In addition, given that sleep disorders and sleep problems are highly persistent, as well as result in more sick visits/calls, it is important that pediatric primary care providers screen for and identify these issues across development. Furthermore, it is essential to provide health care providers with more education and support on sleep disorders and sleep problems in pediatric primary care.
authors.affiliation: National Jewish Health, Denver, CO.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Meltzer
authors.affiliation: University of Michigan, Ann Arbor, MI.
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Plaufcan
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Jocelyn H
authors.initials: JH
authors.lastname: Thomas
authors.affiliation: Saint Joseph's University, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Mindell
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000628:therapy*
keywords: Child; adolescent; pediatrician; sleep issue
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