Journal of Developmental & Behavioral Pediatrics:
Developmental-Behavioral Pediatrics Albert Einstein College of Medicine/Children's Hospital at Montefiore Bronx, NY
Two widely respected authorities in sleep medicine and developmental/behavioral pediatrics have updated this excellent second edition of A Clinical Guide to Pediatric Sleep. Its purpose is to provide practitioners with an overview of the diagnosis, evaluation, and treatment of pediatric sleep disorders, which present in a variety of clinical settings. This guide is a comprehensive reference that reflects current standards of practice and will undoubtedly arm providers with the confidence to adequately assess families' pediatric sleep concerns.
According to the National Sleep Foundation, approximately 40% of childhood is spent sleeping. A disruption in this basic physiological requirement can significantly impact all aspects of child development and behavior, as well as family well-being. Concerns about children's sleep often arise during routine care visits and other subspecialty care settings. Yet decreased patient-physician encounter times frequently limit the provision of thorough anticipatory guidance and further exploration of caregivers' sleep concerns. Despite these limitations, families often turn to health care providers for guidance on such issues.
This edition is divided into 4 sections with each having a distinct focus. The section Introduction to Pediatric Sleep provides a thorough overview of sleep physiology that is detailed yet easily understood by readers of different professional levels. The Sleep in Infancy, Childhood, and Adolescence chapter is well organized by age group, easy to follow, and serves as a review of fundamental pediatric sleep knowledge required to provide age-appropriate anticipatory guidance and troubleshoot sleep complaints. The first section also includes an in-depth approach to the evaluation of sleep concerns, which includes an outline of the elements of a complete sleep history that can help providers narrow down the differential diagnoses and make appropriate referrals.
For readers interested in specific sleep disorders, the book's second section provides a systematic review from more common sleep issues such as bedtime problems and sleep enuresis to less commonly encountered problems such as sleep-disordered breathing and narcolepsy. Highlights of topic reviews include provision of current American Academy of Sleep Medicine Standards of Practice Guidelines, up-to-date diagnostic criteria derived from the International Classification of Sleep Disorders—Second Edition, and practical information that practitioners can give to families about each topic. Additional notable features include a list of current references that supplement topic information, organized by chapter heading. To aid families seeking additional self-education, a list of national organizations and recommendations for books about children's sleep are provided.
An additional notable section addresses a challenging area in sleep medicine—approaches to pharmacological treatments for sleep disorders. Although this subject could warrant an independent volume of work, the authors certainly tackle the salient points in a detailed and succinct manner. The Sleep and Medications section provides readers with a fair understanding of the factors involved in using medications as sleep disorder treatment aids. An overview of different classes of medications, such as those available over the counter and ones used off-label, educates readers about treatment options and provides a framework around which to engage families in discussions about the use of various therapeutics for sleep difficulties.
Finally, the guide has excellent online appendices that include a detailed sleep questionnaire and sleep diary forms, which can be easily adapted to different practice levels and styles. Readers will also appreciate patient handouts on general sleep patterns in different age groups and on sleep disorders discussed in the guide. All handouts can be effortlessly accessed online and quickly distributed during busy office sessions. However, practitioners working with non English-speaking families may welcome handouts in languages other than English.
In summary, this edition provides a well-organized, well-written, informative review of normal pediatric sleep and pediatric sleep disorders. It will prove valuable for primary care practitioners, mental health providers, and trainees such as medical students, residents, and pediatric subspecialty fellows. Whether seeking out a resource for an overall review of pediatric sleep, looking for a topic-specific reference for further patient assessment and workup, or preparing for a specialty examination, readers will surely find this clinical guide an excellent addition to their office library.
Disclosure: The author declares no conflict of interest.
Elisa I. Muñiz, MD
Albert Einstein College of Medicine/Children's Hospital at Montefiore