A Systematic Review of the Management of Paediatric Chronic Insomnia in Primary Care

Talk Code: 
E.3
Presenter: 
Samantha Hornsey
Twitter: 
Co-authors: 
Samantha Hornsey [1], Catherine Hill [1,2], Beth Stuart [1], Ingrid Muller [1] and Hazel Everitt [1]
Author institutions: 
[1] University of Southampton [2] University Hospital Southampton NHS Foundation Trust

Problem

Poor sleep in children can have both physiological and psychological consequences on their development. A form of Chronic Insomnia, Behavioural Insomnia in children (BI) is common and is typically discussed as problems with limit setting and/or with sleep-onset associations. Research indicates that behavioural interventions (e.g. extinction methods, parental education, stimulus control methods) and sleep hygiene interventions are effective treatment strategies (Mindell et al 2006; Allen et al 2016). Primary care offers potential to help families prevent BI or address it early (reducing the risk of consequences of persisting sleep problems). Research on this topic is limited, however, a review (Honaker and Meltzer 2016) suggested that for general sleep problems in paediatric primary care, professionals’ formal training about sleep is limited and that sleep is rarely discussed in appointments. Our review further explores primary care professionals’ (PCPs) current practice, knowledge, and perceptions of role, regarding management specific to BI.

Approach

A systematic search strategy consisting of various terms for ‘sleep’, ‘child’ and ‘primary care’ was conducted in six electronic databases (CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science and Cochrane Library CENTRAL). Studies were selected if they included PCPs seeing families about BI (or parents/children presenting to PCPs with sleep problems) and if they looked at PCPs knowledge, role perceptions or current practice regarding management of BI in primary care. SH lead initial / full text screening and many of the potentially eligible full texts have been screened for full eligibility. SH is leading data extraction and data from included studies to date have been extracted. Further data is being extracted accordingly, as further articles are included from the remaining full texts. Twenty percent of initial results were also screened by BS who will also screen 20% of full texts and check data extraction. Quantitative and qualitative papers will be synthesised with a narrative synthesis and thematic synthesis, respectively. Quality appraisal will be assessed using the Mixed Methods Appraisal Tool.

Findings

There were 7578 results from the databases searches (de-duplicated to 5505). Title and abstract screening resulted in 499 potentially eligible full texts to read. To date, 11 papers have been included for analysis, from which data have been extracted. To date, UK research is lacking. Preliminary synthesis is being conducted whilst the final full texts are being screened. Full results will be presented at the conference.

Consequences

Findings will highlight what PCPs currently know, practice and perceive their role to be, regarding the management of children’s BI. Findings will direct future research which aims to further explore, or improve, particular areas of management of BI within primary care. The lack of UK based studies is notable, indicating that further UK research is warranted.

Submitted by: 
Samantha Hornsey
Funding acknowledgement: 
This project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.