Telehealth Delivery of Therapeutic Intervention for Sleep Disorders in Children and Adolescents Mani

1
Telehealth Delivery of Therapeutic Intervention
for Sleep Disorders in Children and
AdolescentsManisha Witmans, MDGreg Schoepp,
PhD
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Multidisciplinary Team

• Pediatric sleep physician
• Clinical psychologist
• Nurse
• Administrative staff
• Other telehealth coordinators
• Access to other medical specialists

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Daytime Sleepiness in ChildrenConceptual
Framework
Poor Quality and/or Limited Sleep
Neurobehavioral Deficits
Emotional Behavioral Disturbance
Performance Consequences
Academic Failure Social Difficulties Behavior
al Issues Family Disruption
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Types of Sleep Disorders

• Behavioral Insomnia of Childhood
• Circadian Rhythm Disorders
• Medical Disorders Obstructive Sleep Apnea
• Excessive Sleepiness Disorders
• Parasomnias night terrors, sleep walking
• Sleep problems in developmentally delayed
  children

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Clinical Evaluation of Sleep Disorders in Children

• History of Sleep Problem
• Past and current medical history
• Social history / stressors
• Developmental / school history
• Sleep diagnostic tools - Sleep Diary, Sleep
  Habits Questionnaire, Quality of Life Inventory

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Referrals

• Referral locations
• Alberta 94, Saskatchewan 7, NWT 1
• Patients
• 75 new consultations and 64 follow-up visits
• Age range 12 months to 18 years
• Gender female 46, male 54
• Wide range of sleep problems/disorders
  identified
• Follow-up post-treatment at 3 months via
  telephone

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Outcomes to Date

• Improved sleep parameters in children and their
  families
• Improved access to sleep services
• Allows coordination of services
• Can identify other issues (medical/non-medical)
  that
• need attention
• Provision of education and skill enhancement to
  health
• professionals
• Limitations
• physical exam consultation with other
  specialists more intensive psychotherapy

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Acknowledgements
Patients and their families Capital Health
Region Stollery Childrens Hospital Regional
Telehealth Services Alberta Health and
Wellness Manisha Witmans, M.D. Jonathon Eustace,
Ph.D.

• Rochelle Young, R.N.
• Adrienne Witol, Psy.D.
• Bruce Dick, Ph.D.
• Cara Dosman, M.D.
• Val Pochynok, R.N. -
• telehealth
• Betty Santin - telehealth
• Jackie Good - research
• assistant