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

Autor: Mercante A; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy. Electronic address: mercanteanna@outlook.com., Owens J; Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Bruni O; Department of Developmental and Social Psychology, Sapienza University, Rome, Italy., Nunes ML; School of Medicine and Brain Institute (BraIns) - Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, RS, Brazil., Gringras P; Paediatric Sleep Department, Evelina Children's Hospital, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK., Li SX; Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China., Papa S; Polistudium SRL, Milan, Italy., Kreicbergs U; Louis Dundas Centre for Children's Palliative Care, UCL Institute of Child Health, London, UK; Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiold University, Stockholm, Sweden; Department of Women and Child Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden., Wolfe J; Pediatric Palliative Care, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA., Zernikow B; PedScience Research Institute, 45711 Datteln, Germany; Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, 45711 Datteln, Germany., Lacerda A; Department of Paediatrics, Portuguese Institute of Oncology, Lisbon Centre, Portugal; European Association for Palliative Care Children and Young People Reference Group Steering Committee, Wasshington, USA; SIOP Europe Palliative Care Working Group Steering Committee, Brussels, Belgium., Benini F; Pediatric Palliative Care, Pain Service, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.
Jazyk: angličtina
Zdroj: Sleep medicine [Sleep Med] 2024 Jul; Vol. 119, pp. 574-583. Date of Electronic Publication: 2024 May 23.
DOI: 10.1016/j.sleep.2024.05.042
Abstrakt: 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.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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