The Practice of Pediatric Sleep Medicine: Results of a Community Survey
Bibliographic record
Abstract
OBJECTIVE: To assess knowledge, screening, evaluation, treatment practices, and attitudes regarding sleep disorders in children and adolescents in a large sample of community-based and academic pediatricians. DESIGN: Cross-sectional survey. PARTICIPANTS: Six hundred twenty-six pediatricians in Rhode Island, Massachusetts, and Connecticut. INTRUMENT: The Pediatric Sleep Survey, a 42-item questionnaire assessing general and specific sleep knowledge categories; clinical screening, diagnostic, and treatment practices for common pediatric sleep disorders; and practitioner attitudes regarding the impact of sleep disorders in the clinical setting and as a public health issue. RESULTS: On the knowledge section, the mean Total Knowledge score for the respondents was 18.1 +/- 3.5 out of 30 items, with 23.5% of the sample responding correctly on half or less of the items. Pediatricians scored highest on items relating to developmental and behavioral aspects of sleep and parasomnias, whereas the mean percentage of correct responses was <50% for items relating to sleep disordered breathing, excessive daytime sleepiness, and sleep movement disorders. Although only 16.5% and 18.2% of the sample reported not screening routinely for sleep disorders in infants and toddlers, this percentage rose to 43.9% in adolescents. Furthermore, only 38.3% regularly question the adolescents themselves about their sleep. Only about one quarter of the respondents screen toddlers and school-aged children for snoring. In evaluating and treating pediatric sleep problems, 53.2% of the sample never or rarely order overnight sleep studies to assess for obstructive sleep apnea and few use alternative treatment strategies, such as continuous positive airway pressure. A quarter of the sample at least occasionally recommends diphenhydramine and almost half suggests a psychological evaluation for children with night terrors. Finally, the percent of pediatricians rating the impact on children of sleep problems in a variety of domains as important or very important ranged from 49.7% (nonintentional injuries) to 92.6% (academic performance). However, only 46% of the sample felt confident or very confident about their own ability to screen for sleep problems, whereas 34.2% and 25.3% similarly rated their ability to evaluate and treat sleep problems in children. CONCLUSIONS: The results of this survey suggest that there are still significant gaps among practicing pediatricians both in basic knowledge about pediatric sleep disorders, and in the translation of that knowledge into clinical practice. Despite their acknowledgment of the importance of sleep problems, many pediatricians fail to screen adequately for them, especially in older children and adolescents. Additional educational efforts regarding pediatric sleep issues are warranted, and should be targeted at the medical school, postgraduate training, and continuing medical education levels.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".