UK primary care practitioners’ views, understanding and current practice regarding the management of chronic insomnia in young children.

Problem

Paediatric behavioural insomnia, categorised within chronic insomnia (CI), is common and impacts child health and development. Behavioural interventions have been shown to be effective and primary care has potential for addressing CI early. However, a review of paediatric sleep problems in primary care (Honaker and Meltzer, 2016) suggested professional training may be lacking and a systematic review specific to management of CI (pending publication), revealed limited research evidence.

This study aims to explore primary care professionals’ (PCPs) views, understanding, knowledge of paediatric CI (including professional training), current practice regarding management, unmet needs, and whether there are any types of support tool that PCPs would like for management.

Approach

A mixed-methods study (surveys and qualitative interviews) exploring PCPs views, current practice, understanding and training regarding insomnia in children age < 5 years. Participants: UK-practicing PCPs (including community PCPs) such as GPs, health visitors, practice nurses. The survey was advertised via (1) ten local clinical research networks to GP practice staff, (2) an NHS Trust health visitor manager and (3) the community. Survey participants could express interest in a qualitative interview.

The survey used closed or Likert scale questions and open questions. Descriptive statistics, group differences and predictors will be explored with statistical analyses. Qualitative interviews used a semi-structured topic guide with open-ended questions to gather more in-depth data, transcribed verbatim are being analysed in NVivo using inductive thematic analysis.

Findings

Data collection is near completion, with 259 survey participants currently (mostly GP practice staff, n=249). Preliminary analyses indicate most participants ‘agreed’ or ‘strongly agreed’ that CI affects the children and their families and that it is important to advise about/manage CI in primary care. 162 ‘strongly agreed’ (and 104 ‘agreed’) it is important to manage/advise about CI using behavioural interventions. Participants indicated their likelihood of making different recommendations. For example, the highest proportion of respondents indicated ‘never’ for the ‘cry it out’ technique and positive bedtime routines ‘every time’. Likelihood of some other types of recommendations were varied. PCPs confidence levels varied. 218 reported they did not receive formal teaching specific to CI when training to become a health professional. 210 would like to access further sleep teaching opportunities about paediatric CI.

20 interviews have been conducted and are undergoing analysis. Findings will be presented at the conference.

Consequences

Final analysis will highlight PCPs’ views/beliefs, understanding / professional training, and current practice. This will highlight areas for improvement and direct future research. Preliminary analysis suggests it may be useful to develop suitable training materials or resources for PCPs, or to develop suitable resources that PCPs can signpost families to (that discuss various management strategies).