Although pediatric sleep concerns are very common (an estimated 25% of children experience a sleep problem at some point), they tend to be under-diagnosed in the primary care setting. This may be partly because parents don’t always bring up sleep disturbances during visits, particularly beyond the infant and toddler years.
While all children and adolescents should be regularly screened for sleep issues, it is particularly important in a child who:
- Has difficulty concentrating
- Is experiencing a decline in academic performance
- Has behavior problems
- Has concerns about mood or anxiety
When a potential sleep issue is identified, a thorough history should include detailed questions about potential symptoms of sleep-disordered breathing (e.g. snoring, breathing pauses, restless sleep, sweating during sleep) as well as its risk factors (e.g. allergies, asthma, positive family history, gastroesophageal reflux).
Clinicians should also assess daytime sleepiness, insomnia, and sleep practices (including the child's sleep schedule, bedtime routine, electronic media use), and the family's previous attempts at addressing the sleep problems (what did and did not work).
