1 - Children's sleep disorders: a case of serious neglect
Published online by Cambridge University Press: 13 August 2009
Summary
There can be few more striking examples of the gap between clinical need and provision of services than sleep disorders medicine, especially concerning children. Sleep problems are endemic and yet their recognition, diagnosis and treatment constitute a blind spot in medical and other healthcare education. The scope and importance of sleep disorders medicine is grossly underestimated by the limited (often perfunctory) accounts of children's sleep and its disorders in textbooks of paediatrics and child psychiatry.
In clinical practice, major errors are made in all the main categories of sleep disturbance. Sleeplessness is frequently treated symptomatically without considering the underlying cause; excessive sleepiness is commonly misconstrued as laziness or some other form of psychological shortcoming; and the many types of episodic disturbances of behaviour associated with sleep are regularly confused with each other diagnostically. The consequences to patients and their families of these mistakes are inevitably serious.
There are several reasons for this unfortunate state of affairs. One major factor must be the wide-ranging nature of the study of sleep and its disorders which crosses many of the boundaries between conventional disciplines and medical specialties. This poses problems for the more traditional teaching and training programmes where learning and the acquisition of skills are still confined to separate compartments with little attempt at integration. In this setting, multidisciplinary areas of discourse and clinical practice are likely to be poorly represented.
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- Publisher: Cambridge University PressPrint publication year: 2001
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