April 5, 2024
2 minute read
Important points:
- Young people with chronic illnesses and sleep disorders were almost twice as likely to have increased use of health services.
- Circadian rhythm sleep disorders were most strongly associated with increased healthcare utilization.
The presence of sleep disorders is associated with increased health care utilization among young people with chronic illnesses, a study has found. Journal of Clinical Sleep Medicine showed that.
“The results are impressive and suggest that sleep disturbances are clearly involved in sleep disorders. [health care use (HU)] in children with chronic medical conditions (CMC).” Dr. Pranshu A. Adavadkar, Associate Professor of Pediatrics at the University of Illinois at Chicago said in a press release.
Young people with chronic illnesses and sleep disorders were almost twice as likely to have increased use of health services. Image: Adobe Stock
According to the researchers, while sleep disturbances are associated with increased HU in adults, “similar studies in pediatric populations are limited.”
They added that because the incidence of HU is higher in children with CMC, it is “important” to examine the impact of sleep disturbances on HU in this population.
In this study, Adavadkar and colleagues analyzed Medicaid claims data for 16,325 youth ages 0 to 18 enrolled in the Collaborative Care Project for Complex Children.
Each child and adolescent had at least one CMC, including asthma, obesity, overweight, diabetes, and ADHD, but 77% had more than one CMC.
Youth were also divided into three groups based on the number of emergency department visits or hospitalizations in the 12 months prior to study enrollment: 12 months prior to study enrollment;
- Less HU use (no emergency department visits or hospitalizations).
- Moderate HU use (1-3 emergency department visits or 1 hospitalization).and
- High HU usage (4 or more emergency department visits or 2 or more hospitalizations)
Sleep disordered breathing (SDB) was the most common sleep disorder across all age groups.
Researchers found that youth with CMC and any sleep disorder had nearly twice the odds of increased HU (OR = 1.83; 95% CI, 1.67-2.01) compared to youth without sleep disorders. .
Circadian rhythm sleep disorders (OR = 2.45; 95% CI, 1.07-5.64) were most strongly associated with increased HU, followed by SDB (OR = 1.51; 95% CI, 1.17-1.95) and insomnia ( OR = 1.46; 95%) followed. CI, 1.06-2.02).
Adavadkar et al. suggested that the significant association between HU and circadian rhythm sleep disorders “may be due to disrupted sleep patterns, daytime dysfunction, and metabolic dysfunction associated with circadian rhythm disturbances.” did.
They also found that the risk of increased HU decreased with age (OR = 0.94; 95% CI, 0.94-0.95) and among Hispanics (OR = 0.57; 95% CI, 0.45-0.72) and blacks (OR = 0.58; %) was also noted. CI, 0.46-0.73) Youth had nearly 50% lower risk of increased HU compared with white youth.
“Despite poorer sleep quality and higher rates of sleep disorders, caregivers from ethnic minority groups may be less likely to seek medical care, as data suggests parents and caregivers from ethnic minority groups may be less likely to seek medical care. “There is a need to investigate the role of racial disparities in sleep-related medical care-seeking behavior in children who receive medical treatment,” they wrote.
This study had several limitations. Adavadkar et al. found that while most participants belonged to diverse groups, which affects the generalizability of the study, there is a possibility of underdiagnosis of sleep disorders in the pediatric population. “This may have weakened the measured association between HU.”
Ultimately, “understanding the specific sleep disorders that significantly increase the risk of health care utilization will inform targeted interventions and screenings to better manage these high-risk children.” “We can do that,” Adavadkar said.
