Pediatric Sleep Clinic Orientation

Contact Information

Judy Owens, M.D. (Director)
401.444.1614

Julie Boergers, Ph.D. (Rotation Coordinator) 401.444.7086

Diane Santos (Administrative Assistant)
401.444.1614

Katherine Belon (Clinical Research Assistant) 401.444.3250

Emma Locke (Clinical Research Assistant)
401.444.3250

General

The Pediatric Sleep Clinic is a multidisciplinary program designed to provide comprehensive assessment and treatment of child and adolescent sleep problems. Typical presenting problems include bedtime refusal, insomnia, difficulty staying asleep at night, sleepwalking, sleep terrors, nighttime fears, excessive daytime sleepiness, and snoring/breathing difficulties.

Logistics

Pediatric Sleep Clinic meets on Monday afternoons starting at 12:45. We begin with a pre-clinic conference from 12:45-1:30. The purpose of the pre-clinic conference is to review and assign new cases for the week and to present sleep-related didactics. Please feel free to bring your lunch.

While we make every effort to conduct clinic efficiently, certain factors (e.g., patients arriving late to appointments, complex patients, etc.) may sometimes delay us, so please plan to stay until 6:00 if necessary.

Readings

You will receive a packet of sleep-related readings prior to starting clinic. Prior to starting your rotation, it will be helpful to read the articles that provide an overview of diagnosis/treatment of childhood sleep disorders and developmental features of sleep. The other readings can be accomplished during the course of your rotation. Please don’t be daunted by the size of the packet; some of the readings can be skimmed and kept for reference (ask us if you have any questions about the readings or need any help prioritizing which are most critical).

A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems in Children and Adolescents (Mindell, Owens, & Bess, 2003) will be available for your reference during clinic. You may find this to be a very useful resource, and if you would like to purchase a copy, a subsidy is available.

Other Didactic Opportunities

There are a number of opportunities available to you, including sleep-related lectures and grand rounds. The Providence Sleep Research Interest Group meets the third Tuesday of the month at 5:30 in Dr. Carskadon's lab on the Butler campus; the presentations are excellent and your attendance is strongly encouraged. There is also a weekly journal club held at the Butler lab on Fridays at 11am.We will make you aware of other sleep-related educational events as they become available. At the beginning of your rotation, we will show you a patient education video about overnight sleep studies, and you will have an opportunity to observe the beginning of an overnight sleep study if you wish. In addition, we have a rich database of information on pediatric sleep clinic patients, as well as several interesting ongoing studies related to pediatric sleep, so please let us know if you have an interest in collaborating on any of these projects.

Scheduling

The pediatric sleep clinic schedules patients months in advance due to our long waiting list. The number of patients who are booked on a given Friday depends, in part, on the number of staff who will be in attendance. Therefore, please discuss any planned absences with us at the beginning of your rotation. If any planned absences arise during the course of your rotation, please give us as much notice as possible (but at least 2 weeks) to give us an opportunity to try to rebook patients.

Patients

Each trainee is responsible for taking the lead on one new patient evaluation and a number of follow-up patients (in-person or telephone) each week. Chart notes are to be written for each patient seen. In addition, formal reports are generated for new patients (see below). Depending on staffing levels, training levels, and interest, we often conduct evaluations in teams of two. A number of factors determines how patients are assigned, including schedule constraints and training needs. We try to monitor your caseload to ensure that you have seen a representative variety of presenting problems and age groups by the end of your clinic experience. If there are types of patients you have a particular interest in treating, let us know.

Supervision

Supervision is provided by Judy Owens, MD, and (alternating weeks) by Julie Boergers, PhD. After patients are seen, the group discusses each case around the conference table and determines a diagnosis and treatment plan. Families are then given feedback and materials (if applicable) before they leave clinic, and follow-up sessions are scheduled.

Clinic Materials

A wide variety of materials are available in the sleep cart, including an evaluation outline, handouts for families, sticker charts, relaxation tapes, referral lists, etc.

Reports

Sample reports and an electronic report template are available to help you in drafting your reports. Please email a draft of your new patient report to the supervising psychologist within one week (before the next clinic). You will receive comments on your draft the following week (2 weeks after you see the patient). Please take an opportunity during “down time” in clinic to review and discuss the comments with your supervisors (and of course, feel free to contact your supervisors outside of clinic for this purpose). Occasionally comments may raise questions about information that was not gathered in the interview; review with your supervisor whether a phone call to the family is warranted to gather more information. Bring a clean copy of your revisions to clinic the next week, and please remember to clip your original draft (with comments) so we can easily review your revisions.