Abstract
Objective
The American Academy of Pediatrics recommends routine sleep problem screenings during
child well-visits. However, studies suggest a discrepancy between caregiver- and clinician-reported
child sleep problems. The present study examines whether caregiver-reported child
sleep problems (ie, habitual snoring, insomnia symptoms, poor sleep health) and clinician-documented
child sleep problems and management are congruent.
Methods
The sample included 170 caregiver-child dyads (child Mage = 3.3 years, range = 2–5 years; 56.5% girls; 64.1% Black, 20.0% non-Latinx White,
and 4.1% Latinx; 86.5% maternal caregiver reporter). Caregivers’ questionnaire-based
reports of habitual snoring, insomnia symptoms, and sleep health behaviors (nighttime
electronics, caffeine intake, insufficient sleep) were compared with clinician documentation
in the electronic health record.
Results
About 92.3% of children had at least 1 caregiver-reported sleep problem (66% insomnia
symptoms, 64% electronics, 38% insufficient sleep, 21% caffeine, 17% snoring). In
contrast, a substantially lower percent of children had a clinician documented sleep
problem (20% overall; 10% insomnia symptoms, 7% electronics, 0% insufficient sleep,
3% caffeine, 4% snoring), sleep-related referral (1% overall; 0.6% Otolaryngology,
0.6% polysomnogram, 0% sleep clinic), or recommendation (12% overall; 8% insomnia
symptoms, 4% electronics, 0% insufficient sleep, 1% caffeine).
Conclusions
There is a vast discrepancy between caregiver-reported child sleep problems and clinician-documented
sleep problems and management, with a higher proportion of caregiver reports. To benefit
overall child health and well-being, future research and quality improvement initiatives
should focus on enhancing screening tools and educational opportunities to improve
clinician documentation and enhance family conversations about early childhood sleep
problems.
Keywords
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Article info
Publication history
Published online: February 07, 2023
Accepted:
February 1,
2023
Received:
October 6,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors have no conflicts of interest to disclose.
This study found a vast discrepancy between prevalent caregiver-reported early childhood sleep problems (snoring, insomnia symptoms, poor sleep health) and limited clinician-documentation and management of sleep at well-visits, underscoring the importance of enhanced sleep screening and management tools in well-visits.
Identification
Copyright
Copyright © 2023 by Academic Pediatric Association
