Prevalence of diagnosed sleep disorders in pediatric primary care practices.
Prevalence of diagnosed sleep disorders in pediatric primary care practices.
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DOI：
10.1542/peds.2009-2725
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发表时间：
2010-06
期刊：
影响因子：
8
通讯作者：
Mindell JA
中科院分区：
文献类型：
--
作者：
Meltzer LJ;Johnson C;Crosette J;Ramos M;Mindell JA
主要目的是确定国际疾病分类第九修订版（ICD-9）的患病率，即由大型初级保健网络中的儿科提供者诊断的睡眠障碍。次要目的是检查与这些诊断相关的人口统计学变量，并检查可能用于治疗睡眠障碍的药物处方的频率。回顾了2007年154957例接受健康儿童访视的患者（0 - 18岁）的电子病历。收集的信息包括ICD-9睡眠诊断、人口统计学变量、共病注意力缺陷/多动障碍和自闭症谱系障碍、提供者类型和药物。在所有年龄段中，3.7%的青少年有ICD-9诊断为睡眠障碍。最常见的诊断是睡眠障碍，未另行说明，遗尿，睡眠呼吸障碍。睡眠障碍的预测因素因发育年龄组而异，包括生长参数、共病的注意力缺陷/多动障碍或自闭症谱系障碍以及提供者类型。6.1%的样本受试者接受了潜在的睡眠相关药物治疗。这项研究是第一个全面检查ICD-9睡眠诊断的初级保健提供者在一个大的代表性样本0至18岁的儿童。ICD-9睡眠诊断的3.7%患者明显低于流行病学研究报告的患病率，这表明初级保健提供者可能对儿童和青少年的睡眠障碍诊断不足。由于睡眠障碍是可以治疗的，因此本研究的结果表明，在诊断和治疗儿童睡眠障碍方面，需要对初级保健提供者进行额外的教育和支持。
The primary aim was to determine the prevalence of International Classification of Diseases, Ninth Revision (ICD-9), sleep disorders diagnosed by pediatric providers in a large, primary care network. Secondary aims were to examine demographic variables related to these diagnoses and to examine the frequency of prescriptions for medications potentially used to treat sleep disorders. Electronic medical records were reviewed for 154 957 patients (0 –18 years) seen for a well-child visit in 2007. Information collected included ICD-9 sleep diagnoses, demographic variables, comorbid attention-deficit/hyperactivity disorder and autism spectrum disorders, provider type, and medications. Across all ages, 3.7% of youths had an ICD-9 diagnosis for a sleep disorder. The most-common diagnoses were sleep disorder not otherwise specified, enuresis, and sleep-disordered breathing. Predictors of sleep disorders varied according to developmental age group and included growth parameters, comorbid attention-deficit/hyperactivity disorder or autism spectrum disorder, and provider type. Potential sleep-related medications were prescribed for 6.1% of the sample subjects. This study is one of the first to examine comprehensively ICD-9 sleep diagnoses given by primary care providers in a large representative sample of children 0 to 18 years of age. The 3.7% of patients with ICD-9 sleep diagnoses is significantly lower than prevalence rates reported in epidemiological studies, which suggests that primary care providers may be underdiagnosing sleep disorders in children and adolescents. Because sleep disorders are treatable when recognized, the results from this study suggest a significant need for additional education and support for primary care providers in the diagnosis and treatment of pediatric sleep disorders.
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