Development and Validation of an Adolescent Sleep Algorithm for Pediatric Primary Care

Poor sleep quality is a common challenge for many adolescents due to various developmental, environmental, and social factors. Nearly half of all adolescents reported regularly experiencing sleep disruptions. Poor sleep quality among adolescents might have severe mental, emotional, and cognitive consequences including an increased risk for several psychiatric conditions, obesity, and poor academic performance. However, sleep disorders among this population frequently go unreported and are rarely screened during annual well-child exams with primary care providers. The purpose of this project was to develop an evidence-based sleep algorithm for pediatric primary care providers designed to improve screening and treatment of adolescent sleep disturbances. The following research question guided this project: Q1 How will feedback from expert clinicians combined with a critical appraisal of the literature contribute to the creation of an evidence-based adolescent sleep algorithm designed for use in the primary care setting? The algorithm was developed using evidence from a literature review and was designed to be used in conjunction with an existing adolescent sleep screening tool. Validation and open-text suggestions for the algorithm were collected via an online survey of 327 pediatric primary care providers recruited from a national certification board and the primary investigator’s professional networks. Survey data were analyzed using descriptive and open-text categorization methods. The results indicated widespread approval of the algorithm with several important recommendations for improvement, and a revision of the algorithm was completed. The Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals guided the project throughout. Suggestions for a future pilot test of the revised algorithm were proposed. While developing and validating the algorithm was the focus of this phase of the project, later implementation could improve the screening and treatment of adolescent sleep issues in primary care.