International consensus on sleep problems in pediatric palliative care: Paving the way
- PMID: 38833942
- DOI: 10.1016/j.sleep.2024.05.042
International consensus on sleep problems in pediatric palliative care: Paving the way
Abstract
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.
Keywords: Complex healthcare needs; Consensus; Pediatric palliative care; Sleep; Sleep problems.
Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest None.
Similar articles
-
Towards new perspectives: International consensus guidance on dystonia in pediatric palliative care.Eur J Paediatr Neurol. 2025 May;56:24-37. doi: 10.1016/j.ejpn.2025.04.003. Epub 2025 Apr 10. Eur J Paediatr Neurol. 2025. PMID: 40267817
-
Delphi Method to Develop a Palliative Care Tool for Children and Families in Sub-Saharan Africa.J Pain Symptom Manage. 2022 Jun;63(6):962-970. doi: 10.1016/j.jpainsymman.2022.02.021. Epub 2022 Feb 21. J Pain Symptom Manage. 2022. PMID: 35202729
-
Components and principles of a pediatric palliative care consultation: results of a Delphi study.J Palliat Med. 2014 Nov;17(11):1206-13. doi: 10.1089/jpm.2014.0121. Epub 2014 Jul 9. J Palliat Med. 2014. PMID: 25006759
-
Aligning guidelines and medical practice: Literature review on pediatric palliative care guidelines.Palliat Support Care. 2017 Aug;15(4):474-489. doi: 10.1017/S1478951516000882. Epub 2017 Jan 9. Palliat Support Care. 2017. PMID: 28065197 Review.
-
Family experiences with palliative care for children at home: a systematic literature review.BMC Palliat Care. 2020 Oct 24;19(1):165. doi: 10.1186/s12904-020-00672-4. BMC Palliat Care. 2020. PMID: 33099303 Free PMC article.
Cited by
-
Insights From the International Consensus on Neuro-Irritability in Pediatric Palliative Care: Expanding the Known, Challenging the Unknown.Neurol Clin Pract. 2025 Oct;15(5):e200525. doi: 10.1212/CPJ.0000000000200525. Epub 2025 Aug 11. Neurol Clin Pract. 2025. PMID: 40799357 Free PMC article.
References
MeSH terms
LinkOut - more resources
Full Text Sources
Medical