International consensus on sleep problems in pediatric palliative care: Paving the way

International consensus on sleep problems in pediatric palliative care: Paving the way

Mercante A; Owens J; Bruni O; Nunes ML; Gringras P; Li Shirley X; Papa S; Kreicbergs U; Wolfe J; Zernikow B; Lacerda A; Benini F; Li A; Wolfson AR; Marinetto A; Santini A; Zanin A; Kuhn BR; Angelhoff C; Santos CF; Goh DYT; Verrillo E; Zhou ES; Ferreira EAL; Bergstraesser E; Pizza F; Nilsson F; Plazzi G; Wang G; Traslaviña GAA; Moreira GA; Siden H; Hauch H; Huijer HAS; Catalano I; Narang I; Avagnina I; Lopez JGDA; Wille J; Mindell J; Bogetz J; Downing J; Hauer J; Streuli J; Baker J; Spruyt K; Chan K Ching C; Soster LA; Oliveira L; Ragsdale L; Nobili L; Matlen L; Nosetti L; De Zen L; Strambi LF; Stenmarker M; Lopes MC; Blankenburg M; Rios M; Bernadá M; Farquhar M; Frühwald M; Gradisar M; Simakajornboon N; Lazzarin P; Chong PH; Ferri R; Martino-Alba R; Findling RL; Ferreira R; Bin-Hasan S; Kudchadkar SR; Mercadante S; Amarri S; Keenan S; Noce S; de Oliveira ISB; Fagondes S; Suh S; Sheldon SH; Sejersen T; Ceranoglu TA; Crabtree V; Castronovo V

Sleep Medicine

2024

Palliative Care; Sleep; Consensus; Pediatric palliative care; Complex healthcare needs; Sleep problems

Objective Sleep problems constitute a common and heterogeneous complaint in pediatric palliative care (PPC), where they often contribute to disease morbidity and cause additional distress to children and adolescents and their families already facing the burden of life-threatening and life-limiting conditions. Despite the significant impact of sleep problems, clinical evidence is lacking. The application of general pediatric sleep recommendations appears insufficient to address the unique challenges of the PPC dimension in terms of disease variability, duration, comorbidities, complexity of needs, and particular features of sleep problems related to hospice care. Therefore, we initiated an international project aimed at establishing a multidisciplinary consensus. Methods A two-round Delphi approach was adopted to develop recommendations in the areas of Definition, Assessment/Monitoring, and Treatment. After selecting a panel of 72 worldwide experts, consensus (defined as ≥75% agreement) was reached through an online survey. Results At the end of the two voting sessions, we obtained 53 consensus recommendations based on expert opinion on sleep problems in PPC. Conclusions This study addresses the need to personalize sleep medicine's approach to the palliative care setting and its peculiarities. It provides the first international consensus on sleep problems in PPC and highlight the urgent need for global guidance to improve sleep-related distress in this vulnerable population and their caregivers. Our findings represent a crucial milestone that will hopefully enable the development of guidelines in the near future.

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

July List 2024