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Objective: Narcolepsy is a lifelong disease, manifesting with excessive daytime sleepiness and cataplexy, arising between childhood and young adulthood. The diagnosis is typically made after a long delay that burdens the disease severity. The aim of the project, promoted by the "Associazione Italiana Narcolettici e Ipersonni" is to develop Red Flags to detect symptoms for early referral, targeting non-sleep medicine specialists, general practitioners, and pediatricians.Materials and Methods: A multidisciplinary panel, including patients, public institutions, and representatives of national scientific societies of specialties possibly involved in the diagnostic process of suspected narcolepsy, was convened. The project was accomplished in three phases. Phase 1: Sleep experts shaped clinical pictures of narcolepsy in pediatric and adult patients. On the basis of these pictures, Red Flags were drafted. Phase 2: Representatives of the scientific societies and patients filled in a form to identify barriers to the diagnosis of narcolepsy. Phase 3: The panel produced suggestions for the implementation of Red Flags.Results: Red Flags were produced representing three clinical pictures of narcolepsy in pediatric patients ((1) usual sleep symptoms, (2) unusual sleep symptoms, (3) endocrinological signs) and two in adult patients ((1) usual sleep symptoms, (2) unusual sleep symptoms). Inadequate knowledge of symptoms at onset by medical doctors turned out to be the main reported barrier to diagnosis.Conclusions: This report will hopefully enhance knowledge and awareness of narcolepsy among non-specialists in sleep medicine in order to reduce the diagnostic delay that burdens patients in Italy. Similar initiatives could be promoted across Europe. [ABSTRACT FROM AUTHOR]

Objective: To investigate the attitudes, practices and beliefs regarding children's sleep problems; their effect on the family; the actual treatment and beliefs of their efficacy; the basic knowledge of sleep and sleep disorders in children.Methods: A two-page questionnaire was sent to a representative sample of 8050 pediatricians (PED) and 1515 child neuropsychiatrists (ChNP). Questionnaire consisted of several questions on estimation of prevalence of sleep disordered patients, on beliefs about children's sleep difficulties, on the prescribed treatments, on reported effectiveness and on the overall effects of sleep problems on the family. A second questionnaire named Sleep Knowledge Questionnaire (SKQ) consisted of 30 true/false questions on sleep issues concerning 6 areas: developmental issues, sleep hygiene, parasomnias, sleep apnea, narcolepsy and miscellanea.Results: A total of 751 questionnaires were returned: 627 from PED and 120 from ChNP. PED indicated that 18.60% of their patients experienced sleep problems, a lower percentage than that indicated by ChNP (21.81%). Pharmacological treatment was prescribed by 58.54% of PED and by 61.21% of ChNP. Among nonpharmacological treatment, the majority of PED and ChNP recommended the establishment of a bedtime routine while a low percentage recommended Ferber's method. Both categories of physicians scored low in all areas of sleep knowledge investigated and particularly in questions about narcolepsy, sleep apnea and parasomnias.Conclusions: Results of the present study supported the need for more education in sleep and sleep disorders among Italian physicians and the necessity to change the physicians' approach to childhood sleep problems. [ABSTRACT FROM AUTHOR]

Background: During recent years, interest on Sleep Disordered Breathing (SDB) in pediatric age has increased, due to the impact on quality of life, psycho-physical attitude and other serious morbidities if undiagnosed and untreated. Methods: Italian Pediatric Respiratory Diseases Society (SIMRI) SDB-Working Group carried out an exploratory survey in Italy, from January to December 2016, to assess the diagnostic and therapeutic pathways, perception and relevance of SDB in Italian Hospitals. Results: A questionnaire was sent to 180 Pediatric Units (PUs) distributed throughout the Italy; 102 Pediatric Units (PUs; 56.6%) answered and among them 57% dealt with SDB, and 94% recognized SDB as a major problem. Instrumental tests performed by the PUs were saturimetry (66%), nocturnal polygraphy with complete cardio-respiratory monitoring (46%) and full polysomnography (23%). In addition, hospital pediatricians reported that 54% of parents were unaware of the SDB and 84% did not know their complications. In the Northern Italy, the diagnosis was frequently performed with instrumental tools and the treatment was often surgical. In the Southern Italy the diagnosis was clinical, and the treatment was usually with drugs. Conclusions: The results of our study showed a heterogeneity in the diagnosis and treatment of SDB throughout Italy. Parents know little about SDB and their complications. The operator satisfaction was associated with the availability of tools for diagnosing SDB. [ABSTRACT FROM AUTHOR]