Study Explores Discrepancies Between Caregiver, Clinician Reports of Sleep Problems in Children


Although more than 90% of children had at least 1 caregiver-reported sleep problem, only 20% had a clinician-documented sleep problem.



A study found that clinicians often fail to document caregiver reports of sleep problems in children.

The study explored discrepancies between caregiver reports of sleep problems such as insomnia, snoring, and insufficient sleep in their children and clinician documentation and management of these problems. To examine this, the authors gathered a sample of 170 caregiver-child dyads, with children ranging in age from 2 to 5 years. In the sample, 56.6% were girls, 64.1% were Black, 20% were white/non-LatinX, and 4.1% were LatinX. Approximately 86.5% of caregivers were maternal caregivers.1

The authors gave the caregivers a questionnaire prompting them to report any insomnia symptoms, habitual snoring, and general sleep health behaviors, such as caffeine intake and nighttime use of electronics, in their children. The caregiver responses were then compared with the information the child’s clinician documented in the electronic health record.1

The authors found that more than 92% of children had at least 1 caregiver-reported sleep problem—however, only 20% of children had a clinician-documented sleep problem. They identified significant inconsistencies between caregiver reports and clinician documentation of specific sleep problems: 66% of caregivers reported insomnia symptoms compared with 10% of clinicians; 64% of caregivers reported nighttime use of electronics compared with 7% of clinicians; 38% of caregivers reported insufficient sleep compared with 0% of clinicians; 21% of caregivers reported caffeine consumption compared with 3% of clinicians; and 17% of caregivers reported habitual snoring compared with 4% of clinicians.1

“There is a vast discrepancy between caregiver-reported child sleep problems and clinician-documented sleep problems and management, with a higher proportion of caregiver reports,” the authors concluded. “To benefit overall child health and well-being, future research and quality improvement initiatives should focus on enhancing screening tools and educational opportunities to improve clinician documentation and enhance family conversations about early childhood sleep problems.”1


1. Carson M, Cicalese O, Bhandari E, et al. Discrepancies between caregiver reported early childhood sleep problems and clinician documentation and referral. Acad Pediatr. February 7, 2023. Accessed June 7, 2023.

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