Practice Guidelines and Clinical Assessment Tools

Information about Sleep Disorders, posted under Emotional Well-Being, may also be beneficial. While written for an adult audience, some sleep disorder resources may be beneficial for treatment of younger individuals.

Practice Guidelines for Sleep Disturbances

Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome
American Academy of Pediatrics

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Enuresis
American Academy of Child and Adolescent Psychiatry

Practice Parameter for the Use of Stimulant Medications in the Treatment of Children, Adolescents and Adults
American Academy of Child and Adolescent Psychiatry

Clinical Assessment Tools for Sleep Disturbances

Sleep disturbances are usually assessed using a clinical interview.¹ It is important to obtain comprehensive sleep history of all aspects of the sleep-wake cycle, including:^{2, 3}

• Specific sleep complaints
• Number of hours of sleep per day
• Bedtime and awakening time
• Number and duration of naps
• Number and duration of awakenings during the night
• Bedtime routine
• Daytime routine
• Daytime fatigue
• Sleep quality
• Onset and duration of symptoms
• Behavior and school problems
• Consequences of sleep problems
• Medical history
• Bedwetting
• Psychiatric history

Laboratory sleep studies may be indicated if a physiological sleep disorder, such as sleep apnea or narcolepsy, is suspected.²

If a child or adolescent is exhibiting symptoms of enuresis it is important for them to receive a medical examination. It is also important to determine if the family is able to implement a fairly intensive behavior treatment, such as the urine alarm.⁵ Family stress, psychiatric disorders, beliefs about treatment, etc., may need to be targeted before implementing treatment for enuresis.

Self-Report Measures

Screening questionnaires and sleep diaries provide useful information to inform diagnosis and treatment.

• Child's Sleep Habits Questionnaire
• Sleep Diary

¹(Durand, V. M. (in press). Sleep terrors. In J. Fisher and W. O'Donohue (Eds.), Practice guidelines for evidence based psychotherapy.  New York: Kluwer Academic Publications).

²Durand, V. M., Mindell, J., Mapstone, E., & Gernert-Dott, P. (1998). Sleep problems. In. T. S. Watson & F. M. Gresham (Eds.). Handbook of child behavior therapy (pp. 203-219). New York: Plenum Press.

³Moore, B. (in press).Pediatric insomnia.In J. E. Fisher & W. O'Donohue (Eds.). Practitioner's guidelines for evidence based psychotherapy. New York: Kluwer.

⁴McCrae, C. S., Sidney, D. N., Taylor, D. J., & Lichstein, K. L. (in press). Insomnia. In J. Fisher and W. O'Donohue (Eds.), Practice guidelines for evidence based psychotherapy. New York: Kluwer Academic Publications.

⁵Mellon, M. W., & Houts, A. C. (in press). Nocturnal enuresis: Evidence based perspectives in etiology, assessment, and treatment. In J. E. Fisher & W. O'Donohue (Eds.). Practitioner's guidelines for evidence based psychotherapy. New York: Kluwer.