A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems, by Jodi A. Mindell and Judith A. Owens, Hagerstown, MD, Lippincott William & Wilkins, 295 pp., $42.95 in softcover.
This is one of the most comprehensive, yet compact and easy-to-read books on sleep disorders in children. It is an important and necessary resource for every practicing pediatrician and pediatric primary care provider. The book is written to sensitize and it enhances the knowledge of pediatricians about sleep disorders in children. It underscores the facts that sleep disorders in children, when undiagnosed and untreated, become chronic conditions and have global impact on children's physical, emotional, and social development. Further, sleep disorders often coexist with mental health issues, attention deficits, social and school performance concerns in children. The book discusses the homeostatic process and endogenous circadian rhythm preferences of children in different age groups. It provides excellent handouts for anticipatory guidance to parents and has been written in a superb manner.
The authors have classified the sleep disorders using DSM IV criteria and provided the ICD-9 codes for different types of sleep disorders to make office billing easy for the care providers. Chapter 4 discusses the evaluation of sleep disorders that includes comprehensive, yet simple questionnaires on sleep history of the child. It further goes into a differential diagnosis using symptom-based algorithms. The next chapter discusses the diagnosis and management of common sleep problems such as bedtime problems, night wakening, nighttime fears, nightmares, sleepwalking, night terrors, head banging, body rocking, bruxism, sleep apnea, sleep disordered breathing, restless leg syndrome, and periodic limb disorder.
The chapter on sleep and medications is comprehensive and is written extremely well. It discusses most of the common drugs used for sleep disorders as well as drugs having effect on sleep. The medicine list is extensive and includes antihistamines, benzidiazpines, chloral hydrate, clonidine, trazadone, zolpidem (ambien), anticonvulsants, antidepressants, antihistamines, decongestants, steroids, nicotine, caffeine, and also commonly used herbal medicines. The authors take special efforts to discuss sleep issues seen in children with special health care needs. Further they discuss sleep and other medical conditions such as asthma, attention deficits, gastroesophageal (GE) reflux, juvenile rheumatoid arthritis (JRA), migraines, fibromylagia, etc. Sleep, as part of several psychiatric conditions, is also discussed in details.
Amazingly, the authors save the best to the last part of the book in the form of appendices. Appendix A, B, C, &D discuss the tools to diagnose sleep disorders and it includes simple yet comprehensive screening questionnaires, and sleep diaries that can be used for parents. Appendix E has six nicely written handouts on sleeps issues from birth to 18 years, and can be used for providing anticipatory guidance to parents. Appendix F provides diagnosis and management and handouts on 14 common sleep disorders seen in pediatric practice: Bedtime Problems, Nightwakings, Nighttime fears, Nightmares, Sleepwalking, Sleep Terrors, Head banging and Body rocking, Bruxism, Obstructive Sleep Apnea, Restless Legs Syndrome, Periodic Limb Movement Disorder, Narcolepsy, Delayed Sleep Phase Syndrome, Insomnia; and two general handouts as Sleep Tips for children, and adolescents. All of these are extremely useful for parents. Appendix G gives resources to the families for further help in dealing with sleep disorder(s) of their child. Finally the references and the index are written in an organized manner.
The authors deserve to be commended for writing such a comprehensive, compact, easy-to-read book on this important evolving problem in children. It will immensely help pediatric care providers as well as parents enhance their knowledge in diagnosis and early management of sleep disorders in children. This book is must for every pediatric care provider.
Sudesh Kataria, M.D., M.H.A.
Learning Behavioral Program
Brody School of Medicine
East Carolina University
Greenville, North Carolina