Paediatric sleep medicine
Our translational research program for children with sleep disorders is broadly divided into the following areas:
Sleep disordered breathing
Our research program is focussed on the diagnostic tools for sleep disordered breathing. The key areas of current research include:
- Evaluating the accuracy of simple technology to diagnose sleep disordered breathing in the home as compared to more complex monitoring. This research is focussed on well-established technologies i.e. pulse oximeters and how these can be used to optimum benefit. We are also involved in commercial trials evaluating the diagnostic accuracy of new technologies for obstructive sleep apnoea in children.
- Our research continues to have a strong focus on defining reference ranges for children, in particular infants and neonates. The output of this work is being used to determine management of patients when supplemental oxygen is being considered to treat babies being discharged from the neonatal unit. Further international multicentre collaborative work is being developed in this area particularly to define normality in preterm infants.
- Our previous work establishing the role of screening children with trisomy 21 for obstructive sleep apnoea is being further developed with collaborative work investigating the role of CPAP for managing obstructive sleep apnoea.
- Our recent leadership in development of national guidelines for sleep diagnostics has identified several further research questions around providing definitions around the quality of diagnostic investigations for sleep disordered breathing. One aim of our respiratory sleep physiology team is to answer these questions.
Chronic insomnia in children with neurodiversity
Children with neurodiversity (ADHD and ASD) have high rates of chronic insomnia. This has an impact on the physical and emotional health and quality of life of the child and their carers. NHS sleep services have limited capacity to address the needs of this large group of children. Our ambitious NIHR DISCA programme seeks to address this need through the development of a digital intervention. It is supported by multi-centre collaboration and expertise in behavioural science. We have recently piloted sensory bedding in children with ASD. Across studies in children with neurodevelopmental disorders there has been a strong focus on neurocognitive and behavioural outcomes.
Sleep related rhythmic movement disorder (SR-RMD)
We have established an NHS centre of expertise in this condition, with the largest population of children with this sleep disorder in the UK and the world. We have published data on prevalence, clinical and polysomnographic features of this condition. We are leading the way in determining optimum approaches to clinical assessment and criteria for establishing severity of the disorder to guide treatment.
Sleep in the hospital environment
We developed the Sleep for Health in Hospital programme (SHH) which has been adopted and adapted in many national paediatric centres. We are collaborating with centres in the US, Canada and Australia to develop international standards for children’s sleep in hospital.