Clinical services for sleep disorders.

Children's sleep disorders are common and often harmful to development and well being. The clinical services available to affected children and their families need to be improved. At present, professional interest and expertise in sleep disorders medicine is severely limited by the paucity of appropriate teaching and training. The work of a mainly tertiary sleep disorders clinic was reviewed, which showed that accurate diagnosis of a wide range of sleep disorders is possible, and that treatment needs can be specified. Although families appreciated such assessment, the outcome was unsatisfactory in many cases, often because treatment recommendations were not implemented by referrers. Reasons for this appear to include poor communication between referrers and families, and unavailability of treatment resources. A three tier system of service provision is proposed to improve this situation, which rests essentially on better professional training in the sleep disorders field.