Formal screening identifies sleep disorders in children with cystic fibrosis

Sleep disorder screening in routine care identified issues among more than 25% of pediatric patients with cystic fibrosis, according to a poster presented at the North American Cystic Fibrosis Conference.

“Children with cystic fibrosis are four times as likely to have a [sleep disorder] SD and three times as likely to have a moderate to severe SD,” Zeni Scott, MD, pediatric pulmonary fellow at Duke University, and colleagues wrote. “SDs are associated with psychological and cognitive comorbidities such as anxiety, depression, and attention deficits. Additional risks include obesity, immune dysfunction, and cardiovascular disease.”

From January 2022 to March 2022, Scott and colleagues assessed 52 pediatric patients with cystic fibrosis, aged 2 to 18 years, to discover how many patients were eligible for sleep disorder screening during routine care, as well as how many were referred for evaluation or intervention at Duke University’s sleep clinic, according to the study abstract.

Researchers conducted additional assessments that evaluated wait time for an evaluation in the sleep clinic and scheduling for polysomnography, and they sought to identify any screening barriers and obstacles in completing referrals.

Researchers used the BEARS questionnaire — which evaluates bedtime issues, excessive daytime sleepiness, night awakenings, regularity and duration of sleep, and snoring — to determine whether children should undergo sleep disorder screening.

Of the 40 (77%) patients eligible for sleep screening based on BEARS, 23 (58%) underwent screening, which identified sleep problems among six (26%) patients, according to the abstract.

These patients were referred to a telehealth sleep clinic, and three of the six were also referred for polysomnography.

During the study, Scott and colleagues reported several barriers including, lack of prioritization of screening on days where the clinic was busy, disinterest in screening and undermining its value from parents, extended wait time for the sleep clinic and polysomnography scheduling leading to patients or parents canceling their appointments.

“Our process and outcomes will be tracked through December 2022 with stratification by age, race, and type of sleep disturbance,” Scott and colleagues wrote. “Identifying a point person to facilitate sleep visit scheduling is planned.”