June 22, 2024

Vitavo Yage

Best Health Creates a Happy Life

Sleep Disorders Raise ED Risk in Children With Chronic Conditions

3 min read

Summary: A study published in the Journal of Clinical Sleep Medicine finds that children with chronic medical conditions and sleep disorders exhibit nearly double the healthcare utilization rate compared to those without sleep disorders. Led by Pranshu Adavadkar, MD, of the University of Illinois Chicago, the study emphasizes the importance of addressing sleep disorders in pediatric populations, highlighting the need for targeted interventions to mitigate the financial burden and improve health outcomes for affected children and their families.

Key Takeaways: 

  • The study, which analyzed Illinois Medicaid claims data for 16,325 children up to 18 years old, revealed that sleep disorders tend to be underdiagnosed in pediatric populations, potentially leading to stronger associations between sleep disorders and healthcare utilization than observed in the study results.
  • Sleep-disordered breathing, including diagnoses of apnea and snoring, was the most common sleep disorder among children in the study, affecting 14.2% of those with medium healthcare utilization and 20.6% of those with high utilization.
  • Pranshu Adavadkar, MD, the principal investigator of the study, emphasizes the importance of addressing sleep disorders in children with chronic medical conditions to reduce healthcare costs and improve health outcomes for affected families.

The risk of increased health care utilization among children with a chronic medical condition is higher for those who also have a sleep disorder, according to a new study that examined Medicaid claims data.

The study, published in the Journal of Clinical Sleep Medicine, found that among children who had a chronic medical condition, those who also had a diagnosed sleep disorder were nearly two times more likely to have increased health care utilization (odds ratio = 1.83) than those who had no sleep disorder. 

The most common sleep disorder diagnosis was sleep-disordered breathing, which was present in 1,796 children. Those who had sleep-disordered breathing were 1.5 times more likely to have increased health care utilization (OR=1.51). The researchers adjusted the analyses for potential confounders including age, race, and chronic medical conditions.

“The results were impressive, suggesting a clear role of sleep disorders in health care utilization in children with chronic medical conditions,” says principal investigator and lead author Pranshu Adavadkar, MD, associate professor in the department of pediatrics at the University of Illinois Chicago and director of pediatric sleep medicine at the UI Health Sleep Sciences Center, in a release.

Insights into the Study

The researchers extracted Illinois Medicaid claims data for 16,325 children up to 18 years of age. The study population was predominantly urban, with most participants representing ethnic minority groups with low socioeconomic status. Each child had at least one chronic medical condition such as asthma, obesity, diabetes, or attention-deficit/hyperactivity disorder, and 77% of the children had multiple chronic medical conditions. 

Participants were divided into three levels of health care utilization based on their hospitalizations and emergency department visits in the 12 months prior to study enrollment: low (no hospitalization or emergency department visit), medium (one to two hospitalizations or one to three emergency department visits), and high (three or more hospitalizations or four or more emergency department visits).

Chronic medical conditions and sleep disorders were identified using codes from the International Classification of Diseases, 9th Revision and ICD-10. Sleep-disordered breathing—which included diagnoses of apnea only, snoring only, and apnea and snoring combined—was found in 14.2% of children with medium health care utilization and 20.6% of those with high utilization.

Adavadkar noted that children with chronic medical conditions tend to have disproportionately higher health care utilization and costs, and families with lower socioeconomic status—including those covered by the Medicaid insurance program—tend to bear the brunt of these costs. Therefore, one strategy to reduce these costs is to treat comorbid sleep disorders.

“Understanding the specific sleep disorders that significantly increase health care utilization risk can inform targeted interventions and screenings for better management of these high-risk children,” says Adavadkar in a release.

The authors noted that sleep disorders tend to be underdiagnosed in pediatric populations, so the association between sleep disorders and health care utilization may be even stronger than the results of this study demonstrate.

Photo 33513208 © Mark Winfrey | Dreamstime.com

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