Dr Anne Morse on Assessment, Risk of Sleep Disorders in Adolescents

Adolescents who participated in a school-based sleep education and surveillance program were shown in early data to exhibit significant risks of sleep pathology, with factors such as school performance or mental health warranting further investigation, said Anne Marie Morse, DO, pediatric neurologist and sleep medicine specialist, Geisinger.

Transcript

How was the school-based sleep education and surveillance program conducted, and what were some notable findings based on early data?

The Wake Up and Learn program, which is a sleep education and surveillance program, had multiple tiers to it. So, we first developed a website that was used as an educational tool that is easily accessible at any time of day. We complemented that with scheduled strategic educational events with the school, as well as some handouts in the school, notably some palm cards that are a little playing cards that the kids would get almost as like a collectible, but something fun and educational.

The surveillance was something that was planned to be 3 times during the school year—in the beginning of the year, the middle of the year, and at the end of the year. Due to COVID-19, the school district had to delay the first survey because of their own need to be able to better strategize around how they are even educating students.

So, we were able to do 2 sets of surveys. The abstract that we described was describing some of the preliminary results of the first set of surveys. What was most striking about the data that we collected was that we expect that 25% to 30% of children in adolescence may have a chronic sleep disorder. Based on the surveys that we performed, what we identified was that about 60% had responses that were consistent with pathologic sleep habits.

The secondary finding, which I think is also very interesting, because we don't really have good data on the prevalence of excessive daytime sleepiness in adolescence. But if you reflect on the adult population where about 4% to 20% of the adult population is expected to have excessive somnolence, we find that in this population of high school students that it was around 17% to 20% of the students having pathologic responses for excessive daytime sleepiness as well.

Are there any subgroups of adolescents or particular sleep conditions that warrant increased investigation?

So, I think you can answer this question in 2 ways. So, you can either be thinking about the student who has some findings that are very suggestive of sleep pathology–maybe they're falling asleep in school or frequently tardy to school now, that would be some red flags for a sleep problem.

Secondarily, you can think about it as individuals who are high-risk for having a sleep problem because of other features that they may have. So, ADHD [attention-deficit/hyperactivity disorder: they're having declining school performance, they're having mood instability, depression, anxiety. These things should be considered part and parcel with surveillance for sleep pathology, because of the significant implications of when there is a sleep problem, the impact of treating that sleep problem is very positive on the impact of treating those other conditions.

Reference

Morse AM, Blessing K, Snyder M, Liscum D. Wake Up and Learn: A school based sleep education and surveillance program. Sleep. 2021;44(suppl 2):A232. doi:10.1093/sleep/zsab072.586