Pediatric Research Update: Sleep Screening: Implementing an Electronic Health Record-Integrated Pediatric Primary Care Sleep Screener

Each month, the OMA Pediatric Committee reviews a pediatric-focused obesity research update to help keep you up to date about the latest findings. This month’s article explores the impact of integrating a brief sleep screening tool directly into the electronic health record.

Article Summary

A new study by Williamson et al. (2025) showed that adding a short sleep screening tool directly into the EHR helped primary care providers identify more sleep disorders and led to more PSG orders and specialty referrals. This is a simple, practical approach that could also be very useful in Obesity Medicine, where sleep screening is still often missed but could make a big impact

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Article Review

Could there be a more efficient way of screening for Sleep Disorders in both Primary Care and Obesity Medicine Clinics?

The spotlight for this month’s journal article review is on the case-control study by Williamson, et al (2025) entitled, “Implementing an Electronic Health Record-Integrated Pediatric Primary Care Sleep Screener” [1]. In this study, the authors developed their own screening tool that was embedded in their respective clinic EMRs. They acknowledged the time constraints experienced by many primary care clinicians (PCC), and developed a questionnaire that could be answered by the patient/ family or during the vital signs portion of the visit. They identified key sleep domains, based on published guidelines and articles, and were then incorporated into the questionnaire. Hyperlinks were provided for further information, as well as management. The screener was developed in phases with feedback from multiple stakeholders. Educational sessions were organized at practices in order to implement the screener.

The journal article reports that adoption of the screener was quite high at ³80%. Pre-implementation and Implementation metrics were compared in the areas of PCC-rendered sleep disorder diagnosis, PSG order, and referrals. The authors found that the screener did substantially increase the said metrics, although overall, the rates were still low. PCC-related and family-related factors were proposed as possible reasons leading to the lower metrics. More PCC education was postulated as one possible solution.

The authors also found that certain symptoms such as snoring, and insufficient sleep, among others, were consistent with published epidemiologic data. Broad sleep problems were more prevalent in their study which the authors attributed to the Covid pandemic. Other sleep problems with lower than published reported rates were thought to be due to either family-related factors, or the screening questions themselves being inadequate.

The article featured above shows how an EMR-embedded tool can aid in screening for sleep disorders in Primary Care clinics, and by extension, to other settings such as the Obesity Clinic. It is paramount that screening for sleep disorders in these settings be accomplished for several reasons. First, sleep health is an integral part of overall health and a key component to weight management, as well as other aspects that affect Obesity care such as mental and behavioral health. The article did mention this in their introduction. Second, with the shortage of sleep healthcare providers overall, there is larger importance in Primary Care and Obesity Medicine in initiating screening for sleep disorders. The article did mention that one of the limitations of their study is that it was implemented in a network affiliated with an academic medical center with specialty sleep and ENT clinics.

To add to the above, there is currently a shortage of sleep specialists, and especially pediatric-certified sleep physicians in the United States. Sleep Medicine fellowship incorporates pediatric training for all of the 7 basic specialties that it trains. However, non-pediatric healthcare providers may choose to limit the age range of their practice. The American Board of Pediatrics (ABP) publishes data regarding its workforce, including subspecialty geographic locations and numbers, and as of August 2024, there are only 364 pediatric-certified sleep specialists currently practicing in the United States.