Referral criteria from primary care - childhood sleep problem

It is appropriate to consider a referral to a sleep specialist

• if a sleep problem persists despite institution of practical sleep hygiene measures, or,
• if the sleep problem begins to impact the child's mood, behaviour, and learning

Suggested persistent features (despite sleep hygiene measures) that should warrant a referral:

• if a school age child chronically feels unrefreshed on waking up in the morning
• if a school age child finds it difficult to stay awake in the classroom
• if a school age child habitually falls asleep in the classroom or while riding in a car or train for less than half an hour, or naps on returning home from school
• a child who habitually snores
• if a child has difficulty falling asleep or staying asleep through the night that lasts over a month
• if a child has unexplained night time behaviours that keep family members awake

Reference:

1. Kotagal S, Pianosi P. Sleep disorders in children and adolescents. BMJ 2006;332:828-32.