Department of Paediatric Respiratory & Sleep Medicine, Queensland Children's Hospital, Brisbane, Australia.
Child Health Research Centre, Faculty of Medicine, University of Queensland, Brisbane, Australia.
Behav Sleep Med. 2023 Sep 3;21(5):570-584. doi: 10.1080/15402002.2022.2143359. Epub 2022 Nov 11.
Sleep disorders are prevalent in children with Down Syndrome (DS). However, sleep treatment is not always readily accessed by this group. This study aims to understand families' experiences of having a child with DS and sleep difficulties, and in particular, their healthcare experiences, with the goal of informing practice improvements.
We conducted semi-structured interviews with 34 parents (fathers n = 4 and mothers n = 30) with open-ended questions about parents' experiences of sleep, family dynamics, and healthcare. We operationalized a reflexive Thematic Analysis.
Parents normalized their experiences of having a child with DS and sleep problems. Parents acknowledged that sleep disruption has adverse and pervasive impacts on their wellbeing and family dynamics, but also found this difficult to identify as a health problem. They accepted sleep difficulties as a regular part of bringing up any child, particularly one with a disability. When they did seek treatment for their child's sleep difficulties, parents often reported encountering insensitive and inadequate care and described that, at times, healthcare professionals also normalized children's sleep difficulties, resulting in sub-optimal treatment. This included at times failure to refer to tertiary sleep medicine services when required.
Parents' and healthcare professionals' normalization of sleeping difficulties denies that they are both deleterious and modifiable. Practice implications include raising healthcare professionals' awareness of the importance of proactively addressing sleep, with sensitivity to families' normalization strategies, recognizing that families may require prompting to report concerns.
唐氏综合征(Down Syndrome,DS)患儿中普遍存在睡眠障碍。然而,该群体并不总能获得睡眠治疗。本研究旨在了解有 DS 患儿和睡眠困难的家庭的经历,特别是他们的医疗保健经历,以期为实践改进提供信息。
我们对 34 名父母(父亲 n=4,母亲 n=30)进行了半结构化访谈,使用开放式问题询问父母关于睡眠、家庭动态和医疗保健的经历。我们对这些访谈进行了反思性主题分析。
父母将他们有 DS 患儿和睡眠问题的经历正常化。父母承认,睡眠中断对他们的幸福感和家庭动态有不利和普遍的影响,但也发现这很难被视为健康问题。他们接受睡眠困难是养育任何孩子,尤其是残疾孩子的正常部分。当他们确实为孩子的睡眠困难寻求治疗时,父母经常报告遇到不敏感和不充分的护理,并且描述说,有时医疗保健专业人员也将儿童的睡眠困难正常化,导致治疗效果不佳。这包括有时未能在需要时转介到三级睡眠医学服务。
父母和医疗保健专业人员对睡眠困难的正常化否认了它们既具有危害性又可改变的事实。实践意义包括提高医疗保健专业人员对主动解决睡眠问题的重要性的认识,对家庭的正常化策略要敏感,认识到家庭可能需要提示来报告问题。