The University of Oklahoma, in collaboration with The University of Tulsa, has developed a new screening method for sleep disorders in children. This tool is the first of its kind and enables health professionals to evaluate children for various sleep problems simultaneously. As a result, this leads to faster assessments and more specific treatment recommendations.Treatment recommendations.
A recent study published in the journal Behavioral Sleep Medicine introduced a new tool known as a structured clinical interview. This study outlines the effectiveness of the interview questions for various sleep disorders, which often share similar symptoms but require different treatments.
“Children often experience sleep problems, and until now, we didn’t have a way to gain a comprehensive understanding of their sleep,” stated Dr. Tara Buck, an associate professor in the OU School of Community Medicine and a child and adolescent psychiatrist.The structured clinical interview for sleep disorders was developed in Tulsa to streamline the process of identifying and treating common sleep problems. According to Mollie Rischard, Ph.D., who led the development of the interview, it can be time-consuming to pinpoint specific sleep disorders, so this new approach allows for a comprehensive screening of the most common issues. Dr. Rischard, a post-doctoral fellow in the Department of Psychiatry at the OU School of Community Medicine, worked on this project as part of her doctoral studies at The University of Tulsa. She built upon the existing adult comprehensive assessment for sleep disorders to create a meticulous and efficient interview process.The team has done an amazing job of making it suitable for children. After multiple rounds of adjustments and feedback from clinical experts, and ensuring it meets the criteria in the Diagnostic and Statistical Manual (the authoritative guide for diagnosing mental disorders), it underwent testing in a clinical trial. The results showed that it is an effective tool.
The current gold standard for diagnosing sleep disorders is a sleep study, where a child spends the night in a sleep lab connected to sensors that measure the quality of sleep. However, Rischard mentioned that sleep studies are costly and may not be necessary in every case. For example, sleep apnea is a medical issue that needs to be addressed.Diagnosed through a sleep study, but before we make costly referrals and ask families to undergo a sleep study, we want to be as sure as we can that it’s necessary,” she said. “There are a lot of overlapping symptoms among sleep disorders, where a child has difficulty falling asleep and staying asleep, so it’s important to determine what is driving the problems. They may have restless leg syndrome or a disruption in their circadian rhythm. Having a better understanding will give us a better sense of how to treat it. Cognitive behavioral therapy can be effective for several sleep disorders.
“We advocate for targeting sleep problems becThe importance of addressing sleep disorders in children is emphasized by Rischard who stated, “Because there’s such a high degree of daytime impairment when kids don’t sleep well.” He also highlighted that sleep disorders can often lead to misdiagnosis of conditions like ADHD due to symptoms such as hyperactivity. Rischard also mentioned that many sleep disorders in children can be effectively treated through behavioral changes, leading to quick improvements in their overall well-being. The collaboration between OU and TU has resulted in the development of a comprehensive structured clinical interview for pediatric sleep disorders, which is a result of a clinical trial studying a new cognitive behavioral treatment.The treatment for youth with nightmares was developed by Lisa Cromer, Ph.D., a professor of psychology at TU and a volunteer child psychiatry faculty member at OU-Tulsa. She led the development of the treatment because there is a growing recognition in the field that nightmares should be addressed as a singular problem rather than a symptom of another problem. The new structured clinical interview helps identify children who have nightmare disorders.
“There is growing evidence that nightmares are a signal for very serious mental health problems, in particular suicidal ideation and behavior,” Cromer said. “Another big risk factor for suicidality is impulsivity, and we know that people are better able to control impulses when they’ve been sleeping well.”
Cromer’s cognitive behavioral treatment includes techniques such as relaxation, stress management, sleep habits, and visualization to alter dream patterns. Parents also play a role in the treatment process. Although the trial is still ongoing, the initial data shows a promising decrease in suicidal thoughts among children with nightmares after receiving the treatment. Cromer and Buck are planning to release the results of their study soon.
“In the past, nightmares were seen as a symptom of other conditions, and it was believed that they were just a byproduct of those conditions.Buck stated that in the past, there were limited options for treating PTSD and anxiety in children, and the focus was on hoping that the nightmares would improve. However, there are now treatments available that can help children reduce or even eliminate their nightmares, which represents a significant shift in how families and healthcare providers approach this issue.