•  
  •  
 

Abstract

Background

Sleep plays an integral role in a child’s physical and neuropsychological development. Children with sleep disorders are at risk of developing inattention, hyperactivity, and learning difficulties, challenges that impact them, their families, their classmates, and their communities.26 There is a paucity of pediatric sleep medicine providers equipped to partner with families in identifying and addressing sleep disorders. Additional barriers to accessing this specialized care include geographic proximity, parental ability to take time off from work, and hesitance for a child to miss valuable learning time at school. During the SARS-CoV-2 pandemic, our pediatric sleep department transitioned from largely in-person care to a predominantly virtual platform and collected data to monitor the impact of this transition. In this study, we share several key trends that emerged which may have broad implications on how pediatric sleep medicine providers can better support school-aged children with sleep challenges.

Methods

We performed a chart review of all scheduled pediatric sleep medicine visits from June 2019 to June 2021, a time frame that included the pandemic-driven overnight transition from in-person to virtual clinic visits. The STEM framework1 was developed by pediatric telehealth experts to provide a unified approach to assessing the impact of telehealth programs. We applied this framework to the collected data to gauge the impact on the four major domains highlighted in STEM: health outcomes, healthcare delivery, individual experience (patient and provider), and program implementation.

Results

The data demonstrated an increased proportion of completed visits and a decreased proportion of canceled/no-show visits when care was provided virtually. Patients accessing virtual care were doing so from greater distances than those who had in-person visits. The school-aged (5-12 years) cohort utilizing telehealth had notable differences in past medical history, with significantly more Attention Deficit-Hyperactivity Disorder. They also presented with significantly more insomnia and behavioral sleep difficulties.

Discussion

Sleep disorders are common, and school-aged children have much to gain from sleep optimization. However, pediatric sleep care can be challenging to access. Geographic distance and time away from school and work preclude many families from formal sleep consultations. Telehealth allows high-quality pediatric sleep care to be offered in an easily accessible format to those near and far, resulting in clinics running more efficiently and school-aged children, who need it most, to receive the tools they need to sleep soundly. With a convenient click, families are better able to fit virtual sleep consultations into their day, without the stress of travel or the waiting room. They complete more scheduled visits, allowing pediatric sleep medicine departments to deliver care more efficiently. The low-pressure virtual platform also permits families to seek care for behavioral sleep issues. While our department’s transition to predominantly virtual care occurred amidst a pandemic, with many confounding factors limiting the interpretation of the data we collected, the trends seen are very promising.

Key Take Away Points

- Pediatric sleep medicine consultation is a highly needed but scarce resource.

- Pediatric sleep medicine clinics can run more efficiently when utilizing telehealth.

- School-aged children with ADHD or suffering from insomnia may access sleep care at greater rates when care is offered virtually.

Author Biography

Dr. Innessa M. Donskoy received her M.D. from the University of Illinois, Chicago College of Medicine, she completed her Residency at the University of Illinois in Pediatrics and her Fellowship was at McGaw Medical Center of Northwestern University/Ann & Robert H. Lurie Children's Hospital of Chicago. She is currently a full-time pediatric sleep medicine physician at Advocate Children’s Hospital in Park Ridge, IL/Oak Lawn, IL. She is also a Clinical Assistant Professor at the University of Illinois at Chicago College of Medicine for the Sleep Medicine fellowship. Dr. Darius A. Loghmanee received his medical degree from SUNY - Buffalo School of Medicine, Buffalo, completed his residency in Pediatrics at Rush University Medical Center, Chicago, and completed his fellowship in Sleep Medicine at the Rush University Medical Center, Chicago. He is currently the Director of the Pediatric Sleep Medicine at Advocate Children’s Hospital in Park Ridge, IL/Oak Lawn, IL. Matthew J. Balog, DrPH, CCSH, RPSGT, is a pediatric clinical sleep educator at Advocate Aurora Health (Park Ridge, IL). He holds a Doctorate in Public Health from Capella University, a Master’s in Public Health with a concentration in epidemiology from Purdue University Global, and an undergraduate degree in chemistry and history from Northern Illinois University. His career in sleep medicine started in 2005. His current academic focus is on sleep screening programs, population sleep health, and healthcare quality improvement. Dr. Kathleen Webster practices Pediatric Critical Care and is Director of Pediatric Telehealth at Advocate Children’s Hospital. She has worked in in the field of telehealth for over 20 years. She currently holds an MD from the University of Louisville and an MBA from the Isenberg School of Management at the University of Massachusetts Amherst. Her interests include telemedicine for children with complex health needs, researching applications and new developments within telemedicine, and overall improving the quality of care for patients through telemedicine and future innovations.

Download
Submit a Response

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.