Abstract Details

Title Assessing Sleep Quality in Children with Migraines: Implementation of Electronic Health Record Cue

Topic Headache

Presentation(s) S4 - Hot Topics in Headache Medicine (1:48 PM-2:00 PM)

Poster/Presentation
Number 005

Background Poor sleep quality is a known trigger for migraine and their relationship is well established in the literature. There is often a lack in exposure of clinicians to sleep quality questionnaires. This fact paired with the ever increasing incentive to speed up patient visits, frequently results in patient’s sleep hygiene and habits unexplored during clinic visits.

Objective To implement an electronic health record (EHR) alert to screen pediatric patients with migraines seen in the headache and neurology clinics for sleep quality using Child and Adolescent Sleep Checklist (CASC), and to evaluate the effectiveness of the alert in screening children with migraines for sleep quality; to use actigraphy as a tool to study sleep quality in patients who were identified to have poor sleep habits using CASC.

Design/Methods

The first step of the study was a 3 month retrospective review of patients less than 21 years of old with migraines to determine the percentage of patients in whom sleep quality was assessed. We implemented the CASC questionnaire in the EHR and providers were encouraged to use the questionnaire to assess the sleep habits. Those who scored higher than 18 were referred to see sleep medicine specialist to address the sleep habits. The percentage of patients in whom sleep quality was assessed and poor sleep quality was identified prior to and after implementation of EHR alert was determined.

Results Prior to EHR alert implementation, 5/90 (0.06%) patients with migraines were assessed for sleep quality. Post implementation, 122/135 (90.4%) patients were assessed for sleep quality using CASC implemented in EHR. 70/122 patients scored higher than 18 on the questionnaire and were referred to sleep medicine specialist / polysomnography. Actigraph was completed in only 14 subjects.

Conclusions Assessing sleep habits using CASC cued in the EHR demonstrated markedly improved identification of children with migraine with poor sleep habits.

Authors/Disclosures
Praveen Ramani, MBBS (Arkansas Children's Hospital.) PRESENTER	Dr. Ramani has nothing to disclose.
Ezgi Saylam, MD (Nationwide Children's Hospital)	Dr. Saylam has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Aravindhan Veerapandiyan, MD (Arkansas Childrens Hospital/UAMS)	Dr. Veerapandiyan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AMO Pharma, AveXis, Biogen, Edgewise Therapeutics, FibroGen, Novartis, Pfizer, PTC Therapeutics, Sarepta Therapeutics, Inc., UCB Pharma, Catalyst, Entrada, Scholar Rock, Catalyst, Lupin. Dr. Veerapandiyan has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. The institution of Dr. Veerapandiyan has received research support from AMO Pharma, Capricor Therapeutics, Edgewise Therapeutics, FibroGen, Muscular Dystrophy Association, Novartis, Parent Project Muscular Dystrophy, Pfizer, RegenxBio and Sarepta Therapeutics. Dr. Veerapandiyan has received personal compensation in the range of $5,000-$9,999 for serving as a MD with PPMD, MDA.