Paediatric Sleep Medicine Clinical Network

Sleep-medicine-identifier

Purpose of the Network

The purpose of the New Zealand Paediatric Sleep Medicine Clinical Network is to establish a multi-disciplinary network that will support New Zealand health care professionals working across community, primary, secondary and tertiary services to deliver an equitable, high quality, cost effective and integrated sleep medicine service for children, young people and their families/whanau.

The New Zealand Paediatric Sleep Medicine Clinical Network will provide clinical leadership in the development and maintenance of the nation-wide clinical service for children and young people up to 15 and when appropriate, 18 years of age, aiming to meet basic international benchmark standards.

Over the last 15-20 years there has been increased recognition of the importance of sleep for children's health. Sleep problems and disorders are common. It is estimated that 1 in 4 children and young people have a problem with sleep that warrants a doctor's attention.  There are over 60 different diagnosable paediatric sleep disorders ranging from behavioural or non-respiratory conditions (e.g. night terrors or parasomnias) to respiratory disorders of sleep, the commonest being obstructuctive sleep apnoea.

Guideline for the assessment of sleep-disordered breathing in children

About one third of children snore; about 10% snore most nights. As a symptom, snoring is often not considered unusual or to have health consequences. The impact is underappreciated by parents and families and often not mentioned or raised as a health issue with General Practitioners.

The way children present is often different than adults. An awareness of the potential significance of poor quality sleep in children is very important. Even in mild cases of Obstructive Sleep Apnoea (OSA) and in young children, untreated OSA may result in significant adverse consequences including impacts on cardiovascular health (e.g. hypertension) and poor sleep quality, leading to impaired daytime functioning affecting development, behaviour and learning.

Symptoms of sleep disordered breathing should be sought in any child with enlarged tonsils and/or disturbed or unrefreshing sleep, particularly if they have underlying comorbidities such as Down syndrome, obesity, previous cleft, craniofacial abnormalities or neuromuscular weakness, as the prevalence of underlying OSA and its subsequent consequences may be greater. OSA can often be diagnosed without the need for elaborate tests and treated effectively with adenotonsillectomy. However where the diagnosis is in doubt, there are underlying comorbidities, anaesthetic risk or ENT intervention fails to resolve symptoms, formal evaluation using sleep studies and consideration to other treatments (e.g. respiratory support) may be required.

The New Zealand Guidelines for the Assessment of Sleep-Disordered Breathing in Childhood 2014 was produced by the National Paediatric Sleep Medicine Clinical Network as an evidence-based summary for the assessment of children with sleep disordered breathing. It aims to address the following clinical management issues for paediatric health care professionals in New Zealand:

  1. How should general practitioners and paediatricians approach the investigation of a child who snores?

  2. Which children should be referred from around New Zealand to a sleep disorders centre for further evaluation?

  3. What treatments are available for disorders of breathing during sleep in childhood and what are the known benefits of these treatments?

The full guideline can be downloaded here. A shorter guideline is available in the guidelines index on the Starship website.

Information for parents and family

Information on sleep from Kidshealth.org.nz

Does your child have a sleep disorder? Tune in here for the Radio NZ Morning Report featuring Drs Liz Edwards, Alex Bartle and Angela Campbell.

Conferences and events in 2018/2019

Sleep in Aotearoa 11 May 2018, Wellington https://www.sleep.org.au/nz-branch/sleep-in-aotearoa 

British Sleep Society Hands-on Sleep 2018 17-18 May 2018, Dundee https://www.sleepsociety.org.uk/bss-hands-on-2018/ and other upcoming events https://www.sleepsociety.org.uk/events/ 

32nd Annual Meeting of APSS Sleep 2019. APSS (Associated Professional Sleep Societiies, a joint partnership of the American Academy of Sleep Medicine and the Sleep Research Society) June 2-6 2018, Baltimore Convention Centre, Baltimore, United States http://www.sleepmeeting.org/ 

9th Annual South GP CME South Meeting 16-19 August 2018, Horncastle Arena, Christchurch, NZ. http://www.gpcme.co.nz/south/ 

Sleep Training for Professionals 
http://www.uhs.nhs.uk/OurServices/Childhealth/Childrenssleepdisorderservice/Sleeptrainingforprofessionals.aspx 
University Hospital Southampton, NHS Foundation Trust, Southampton, Hampshire 
    One Day Sleep Training Course
    11th of September 2018
    Managing Children's Sleep Disorders in Clinical Practice
    30th - 2nd November 2018 - 4 day course
    Sleep Update & Case Study Day
    30 November 2018
    Mercure Wessex Hotel, Paternoster Row, Winchester

24th Congress of the European Sleep Research Society, 25 - 28 September 2018, Basel, Switzerland https://www.esrs-congress.eu/2018.html

30th Annual Scientific Meeting of the Australasian Sleep Association (ASA) and Australasian Sleep Technologists Association (ASTA)  17-20 October 2018, Brisbane Convention and Exhibiton Centre, Brisbane, Australia. For more information click here

Annual Dental Sleep Medicine Course, 17-19 October 2018, Brisbane Convention and Exhibition Centre, Brisbane, Australia. http://www.dentalsleepmedicine2018.com.au/

Association for respiratory technology and physiology (ARTP) 2019 Conference, January 31-February 1 2019, Doubletree by Hilton, Glasgow  https://mailchi.mp/ce2299022e0f/artp-conference-2019-registration-now-live

World Sleep Day 2019, Friday March 15th 2019 http://worldsleepsociety.org/programs/world-sleep-day/

Sleep in Aotearoa, May 2nd to 3rd, 2019, Christchurch, NZ https://www.sleep.org.au/nz-branch/sleep-in-aotearoa

33rd Annual Meeting Sleep 2019  APSS (Associated Professional Sleep Societies, a joint partnership of the American Academy of Sleep Medicine and the Sleep Research Society), June 8-12 2019, Henry B. Gonzalez Convention Center, San Antonio, Texas, United States http://www.sleepmeeting.org/future-meetings   https://aasm.org/nominate-speakers-for-sleep-2019-annual-meeting/

Rotorua GP CME 2019, 12-16 June 2019, Rotorua Energy Events Centre, Rotorua, NZ http://www.gpcme.co.nz/login.php

10th Annual South GP CME South Meeting, 08-11 August 2019, Horncastle Arena, Christchurch, NZ South GP CME 2019  http://www.gpcme.co.nz/south/login.php

World Sleep 2019 Congress on Sleep Medicine, September 20-25 2019, Vancouver, Canada https://worldsleepcongress.com/worldsleep2019

Sleep DownUnder 2019. 17-19 October 2019, Sydney, Australia  https://www.sleep.org.au/conferences/external-events/sleep-downunder-future-dates

For further information on PSNZ / MoH Clinical Network development, please contact PSNZ CEO, Mollie Wilson, mollie@healthnetworks.co.nz or PSNZ Secretariat Denise Tringham, denise@paediatrics.org.nz