Understanding patient characteristics and medication prescriptions in children with mental health and neurodevelopmental disorders referred to a sleep clinic—A quality improvement/quality assurance analysis

Ipsiroglu, O.; Bhathella, Juhi; Boldut, Renee Paula; Elbe, Dean; Hill, Olivia; Keys, Elizabeth; McWilliams, S.; Silvestri, Rosalia; Wensley, David F.

doi:10.3389/fpsyt.2022.878356

Cited by 3 publications

(1 citation statement)

References 43 publications

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“…First, we agreed that a visualized medically informed screening framework was of the utmost importance for making our clinical knowledge transparent and available. This model aims to overcome compartmentalization in the communities as well as in academic settings ( 16 , 55 , 56 ). Given the complexity of individual biopsychosocial circumstances, the first step was the re-set of categorical day and nighttime-related diagnoses (e.g., ADHD and insomnia, respectively) in equal relation.…”

Section: Integrating a Medical And Socio-ecologic Framework In Sleep ...mentioning

confidence: 99%

Social-ecological considerations informing a universal screening strategy for sleep health in the community

et al. 2023

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“Poor sleep health” (PSH), defined as reduced amount of sleep and non-restorative sleep, affects cognitive, social and emotional development. Evidence suggests an association of sleep deprivation and mental health problems; however, there are no universal concepts allowing a first-tier screening of PSH at a community level. The focus of this narrative review is to highlight the cultural context of the current medicalized approach to PSH and to suggest social ecological strategies informing new and holistic community-based screening concepts. We present two conceptual screening frameworks; a “medical” and a merged “social emotional wellbeing framework” and combine them utilizing the concept of “ecologies.” The first framework proposes the incorporation of “sleep” in the interpretation of “vigilance” and “inappropriate” labeled behaviors. In the first framework, we provide a logic model for screening the myriad of presentations and possible root causes of sleep disturbances as a tool to assess daytime behaviors in context with PSH. In the second framework, we provide evidence that informs screening for “social emotional wellbeing” in the context of predictive factors, perpetuating factors and predispositions through different cultural perspectives. The distinct goals of both frameworks are to overcome training-biased unidirectional thinking and a priori medicalization of challenging, disruptive and/or disobedient behaviors. The latter has been explicitly informed by the critical discourse on colonization and its consequences, spearheaded by First Nations. Our “transcultural, transdisciplinary and transdiagnostic screening framework” may serve as a starting point from which adaptations of medical models could be developed to suit the purposes of holistic screening, diagnosis, and treatment of complex childhood presentations in different cultural contexts.

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Section: Integrating a Medical And Socio-ecologic Framework In Sleep ...mentioning

confidence: 99%

Social-ecological considerations informing a universal screening strategy for sleep health in the community

et al. 2023

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Phenotyping sleep disturbances in ADHD and identifying harmonised outcome measures

Ipsiroglu,

Klösch,

Stein

et al. 2024

Somnologie

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Attention deficit hyperactivity disorder (ADHD) is a widespread neurodevelopmental disorder. Currently, the diagnosis and treatment of ADHD in children and adolescents is primarily centred on daytime functioning and the associated impairment of academic performance, although disrupted and restless sleep have been frequently reported in individuals with ADHD. Further, it has been recognised that sleep disorders not only intensify existing ADHD symptoms but in some cases can also mimic ADHD symptoms in the paediatric population with primary sleep disorders. Under the title ‘The blind spot: sleep as a child’s right issue?’, professionals from diverse disciplines, including medicine and social sciences as well as individuals with an interest in ADHD and sleep medicine, including laypeople, have initiated a unifying discourse. The objective of this discourse is to improve our understanding of the diagnosis and treatment of ADHD and disruptive behaviours and to develop personalised and precision medicine. Research has shown that the existing, primarily descriptive and categorical diagnostic systems do not capture the heterogeneous nature of youth with attentional and behavioural difficulties and the phenotypic expressions thereof, including nighttime behaviours and sleep. New strategies for clinical phenotyping and the exploration of patient-reported behaviours are necessary to expand our understanding and develop personalised treatment approaches. In this position paper, we outline gaps in the clinical care of ADHD and related sleep disturbances, review strategies for closing these gaps to meet the needs of individuals with ADHD, and suggest a roadmap for escaping the one-size-fits-all approach that has characterised ADHD treatment algorithms to date.

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Staying vigilant about the sleep–wake states—is one question the whole story?

Ipsiroglu,

Klösch,

Spruyt

2024

Sleep Advances

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Understanding patient characteristics and medication prescriptions in children with mental health and neurodevelopmental disorders referred to a sleep clinic—A quality improvement/quality assurance analysis

Cited by 3 publications

References 43 publications

Social-ecological considerations informing a universal screening strategy for sleep health in the community

Social-ecological considerations informing a universal screening strategy for sleep health in the community

Phenotyping sleep disturbances in ADHD and identifying harmonised outcome measures

Staying vigilant about the sleep–wake states—is one question the whole story?

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