Pediatric Sleep Disorders in an Outpatient Sleep Clinic: Clinical Presentation and Needs of Children With Neurodevelopmental Conditions

Abstract

Although sleep problems in youth with neurodevelopmental conditions (NDC) tend to be more prevalent and severe than those of typically developing (TD) youth, their clinical presentations and needs are rarely compared in real-world settings. This study compared sleep patterns, diagnostic impressions, and treatment recommendations between a diverse outpatient sample of TD youth and those with NDC. Data were collected from electronic medical records for 327 consecutive patients (58.4% male; 52.6% White, age range = 0–20 years) presenting for an initial consultation at an outpatient sleep clinic in an urban children’s hospital. Of the sample, 45.3% had a preexisting NDC, with 7% diagnosed with autism spectrum disorder (ASD), 9.9% with Trisomy 21 or other genetic disorder, 26.8% with another developmental delay, and 16.5% with ADHD. Obstructive sleep apnea (OSA) was the most frequent diagnosis overall (64.5%). However, patients with Trisomy 21 or other genetic disorders were especially more likely than TD youth to receive an OSA diagnosis and to receive medical treatment recommendations or referrals, but less likely to receive behavioral recommendations. Although patients with ADHD presented with higher rates of OSA symptoms, patients with ADHD and/or ASD did not differ in any other ways from TD patients in their sleep patterns, diagnosis, or treatment recommendations. Findings underscore the range of sleep problems in TD youth and those with NDC. The breadth of services provided at pediatric sleep centers highlights the importance of referral to such centers when sleep problems are present, especially in children with NDC.