# Clinician Perceptions Around Management of Sleep Problems in Children With Neurodisability

## TL;DR

This study explores how clinicians from various pediatric fields manage sleep problems in children with neurodisability, finding inconsistent confidence and training.

## Contribution

The study identifies key barriers and proposes the need for national guidelines and training to improve sleep management in children with neurodisability.

## Key findings

- Clinicians report limited training and confidence in managing sleep disorders in children with neurodisability.
- Informal methods are predominantly used for sleep screening, with limited use of validated tools.
- National guidelines and enhanced training are recommended to support standardized sleep management.

## Abstract

Children with neurodisability (ND) experience higher rates of sleep disorders when compared to typically developing children. Children with ND frequently receive care from multiple medical services; sleep problems are commonly mentioned by caregivers and encountered by clinicians across various disciplines. However, the perspectives of these clinicians on managing sleep in this cohort of children are not widely understood. This study aimed to explore how clinicians from diverse paediatric fields perceive their role in the assessment and management of sleep disorders in children with ND.

A cross‐sectional survey involving clinicians across multiple specialty disciplines (excluding sleep medicine) from three tertiary paediatric hospitals in Australia was conducted. The survey included multiple choice questions, free text responses and case studies. Data analysis included quantitative (descriptive) statistics and thematic analysis of free text responses.

Ninety‐five clinicians participated. Of these, 80% of clinicians (n = 77) identified sleep as a significant issue in this population, with sleep problems regularly raised by families within routine consults. Clinicians reported predominantly (70%) relying on informal methods to screen for sleep, with limited use of validated screening tools. Confidence in managing sleep varied across specialties and sleep disorder presentations, with medical specialists generally confident across all sleep presentations. Clinicians reported offering treatment advice to families, while simultaneously reporting limited training and confidence. A lack of training, unclear referral pathways and time constraints were described as barriers for management.

Non‐sleep specialised clinicians describe challenges when managing sleep in children with neurodisability. Findings support the development of national clinical guidelines to provide a more consistent approach to sleep management.

Our findings show variability in clinicians' confidence levels in managing sleep concerns.Key barriers identified include limited training, unclear referral pathways and time constraints.Clinicians highlighted the need for national guidelines to support a more standardised approach to sleep management in this population.Enhanced formal training and the development of practical resources were recommended.Upskilling allied health professionals in sleep‐related care may help mitigate time limitations faced by medical staff and support more effective multidisciplinary management.

Our findings show variability in clinicians' confidence levels in managing sleep concerns.

Key barriers identified include limited training, unclear referral pathways and time constraints.

Clinicians highlighted the need for national guidelines to support a more standardised approach to sleep management in this population.

Enhanced formal training and the development of practical resources were recommended.

Upskilling allied health professionals in sleep‐related care may help mitigate time limitations faced by medical staff and support more effective multidisciplinary management.