Sleep Problems in Pediatric Practice: Clinical Issues for the Pediatric Nurse Practitioner

Jodi A. Mindell, PhD; Judith A. Owens, MD, MPH


J Pediatr Health Care. 2003;17(6) 

In This Article


There are number of resources currently available for pediatric nurse practitioners, both in terms of information for the practitioner and information available for families.

Tools and information on pediatric sleep problems are available from a number of domains.

Clinical Screening and Diagnostic Tool. One simple sleep screening algorithm, the "BEARS", is outlined in Table 5 . This 5-question screening tool for pediatric sleep problems has been shown to yield significantly more sleep information in general and about specific sleep domains than the use of a standard single question (e.g., "does your child have any sleep problems?" ) and to increase the likelihood of identifying sleep problems in the primary care setting.

Written Materials. Several comprehensive books on pediatric sleep disorders are available, including Principles and Practices of Sleep Medicine in the Child (WB Saunders, 1995) and Pediatric Sleep Medicine (WB Saunders, 1997). An excellent resource on adolescent sleep is Adolescent Sleep Patterns: Biological, Social, and Psychological Influences (Cambridge University Press, 2002). The authors of this paper recently released a book, entitled A Clinical Guide to Pediatric Sleep: Diagnosis and Treatment of Sleep Problems (Lippincott, Williams, & Wilkins, 2003) that provides comprehensive information on pediatric sleep and sleep disorders for primary care pediatric practitioners.

A regularly updated list of key articles on basic pediatric sleep issues can be found on the Web site.

Web-Based Materials. A section of the internet site for the American Academy of Sleep Medicine (AASM; program was developed to improve the quality of education in sleep medicine through identification of needs, implementation and dissemination of programs and resources designed to address these needs, and assessment of outcome. Medsleep is a joint effort of the SAA program and the AASM, and currently offers over 50 regularly updated educational products free of charge, including powerpoint slide sets, videotaped case histories, surveys/questionnaires, curriculum outlines, and case studies for problem-based learning.

Other websites of note include the University of California-Los Angeles's (teaching, research, references) and the Brown Medical School website, (educational tools, clinical information, research). These sites provide helpful information on sleep in children and adolescents. Furthermore, a listing of accredited sleep disorders centers can be obtained from the American Academy of Sleep Medicine's website (

Pediatric nurse practitioners can make a number of resources available to their patients.

National Sleep Foundation. The National Sleep Foundation (NSF) is an independent nonprofit organization dedicated to improving public health and safety by achieving understanding of sleep and sleep disorders, and by supporting education, sleep-related research, and advocacy. In addition to a broad range of resources on adult and pediatric sleep, the NSF developed a brochure entitled "Sleep, Your Baby and You," which provides best sleep practice guidelines for newborns, infants and toddlers. This free brochure is based on a consensus statement developed by pediatric and sleep experts and focuses on the prevention of sleep problems, rather than the treatment of already existing issues. Free copies may be obtained for the pediatric practice by calling (877) JNJ-BABY.

Parent Handouts. The book mentioned above written by the authors of this paper has a CD-ROM that includes patient handouts on sleep for every age group and for every sleep problem (e.g., nightwakings, nighttime fears, sleepwalking, obstructive sleep apnea, and insomnia).

Parenting books. There are a number of excellent books specific to sleep problems in children that parents can be referred to, including:

  • Ferber, R. (1985). Solve your child's sleep problems. New York: Fireside.

  • Mindell, J. A. (1997). Sleeping through the night: How infants, toddlers, and their parents can get a good night's sleep. New York: HarperCollins.

  • Weissbluth, M. (1999). Healthy sleep habits, happy child. New York: Fawcett Books.

Parenting Internet Sites. There are many internet sites that provide comprehensive information on all aspects of children and adolescent sleep issues, including the website for the National Sleep Foundation (, as well as,, and


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