PURPOSE: Obstructive Sleep Apnea (OSA) is a common medical condition in children with serious adverse consequences including neurocognitive deficits and behavioral problems. The American Academy of Pediatrics (AAP) has issued a Clinical Practice Guideline on Diagnosis and Management of OSA in 2002. The purpose of this study was to determine if community pediatricians were aware of these guidelines and to assess their screening practices for OSA.
METHODS: The Pediatric Sleep Survey, a validated sleep questionnaire, was used. Respondents were asked to select specific sleep history items focusing on snoring and sleep disordered breathing (SDB) that they routinely include greater than 75% of the time as part of a well child visit in infants, toddler/pre school, school age and adolescent children. Community pediatricians affiliated with our Department of Pediatrics were contacted by email to participate in the survey. A web based survey engine (www.surveymonkey.com) was used to collect responses and analyze results.
RESULTS: Response rate was 33%. 55% (36/65) of respondents were not aware of the AAP practice guideline or its recommendations. 28% of respondents (18/65) did not screen for snoring and SDB. Over 90% of respondents screened high risk school aged and adolescent children for snoring. Items screened for by more than 90% of respondents in toddlers/ preschool were: restless sleep and daytime behavior problems; in school aged: difficulty waking, daytime sleepiness and daytime behavior problems; in adolescents: restless sleep, difficulty waking, & daytime sleepiness.
CONCLUSION: There was limited awareness of the AAP guidelines amongst community pediatricians in our immediate referral area. A significant proportion of respondents did not screen for snoring. A large proportion of respondents screened high risk age groups for subtle symptoms of SDB like behavior problems and difficulty wakening.
CLINICAL IMPLICATIONS: Awareness of the AAP guideline remains low among pediatricians. All pediatricians do not screen for snoring, as recommended by the AAP. Our findings emphasize the importance of continuing to educate primary care physicians to screen children for OSA and sleep disordered breathing at well child visits.
DISCLOSURE: Sumit Bhargava, No Financial Disclosure Information; No Product/Research Disclosure Information