BEARS SLEEP SCREENING ALGORITHM
BEARS SLEEP SCREENING ALGORITHM
The “BEARS” instrument is divided into five major sleep domains, providing a comprehensive screen for the major sleep disorders affecting children in the 2- to 18-year old range. Each sleep domain has a set of age-appropriate “trigger questions” for use in the clinical interview.
B = bedtime problems
E = excessive daytime sleepiness
A = awakenings during the night
R = regularity and duration of sleep
S = snoring
Examples of developmentally appropriate trigger questions:
| |Toddler/preschool |School-aged |Adolescent |
| |(2-5 years) |(6-12 years) |(13-18 years) |
|1. Bedtime |Does your child |Does your child |Do you have any |
|problems |have any problems |have any problems|problems falling |
| |going to bed? |at bedtime? (P) |asleep at |
| |Falling asleep? |Do you have any |bedtime? (C) |
| | |problems going to| |
| | |bed? (C) | |
|2. Excessive |Does your child |Does your child |Do you feel sleep|
|daytime |seem overtired or |have difficulty |a lot during the |
|sleepiness |sleepy a lot |waking in the |day? In school? |
| |during the day? |morning, seem |While driving? |
| |Does she still |sleepy during the|(C) |
| |take naps? |day or take haps?| |
| | |(P) Do you feel | |
| | |tired a lot? (C) | |
|3. Awakenings |Does your child |Does your child |Do you wake up a |
|during the night |wake up a lot at |seem to wake up a|lot at night? |
| |night? |lot at night? |Have trouble |
| | |Any sleepwalking |getting back to |
| | |or nightmares? |sleep? (C) |
| | |(P) Do you wake | |
| | |up a lot at | |
| | |night? Have | |
| | |trouble getting | |
| | |back to sleep? | |
| | |(C) | |
|4. Regularity and|Does your child |What time does |What time do you |
|duration of sleep|have a regular |your child go to |usually go to bed|
| |bedtime and wake |bed and get up on|on school nights?|
| |time? What are |school days? |Weekends? How |
| |they? |Weekends? Do you|much sleep do you|
| | |think he/she is |usually get? (C) |
| | |getting enough | |
| | |sleep? (P) | |
|5. Snoring |Does your child |Does your child |Does your |
| |snore a lot or |have loud or |teenager snore |
| |have difficult |nightly snoring |loudly or |
| |breathing at |or any breathing |nightly? (P) |
| |night? |difficulties at | |
| | |night? (P) | |
(P) Parent-directed question
(C) Child-directed question
Source: “A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems” by Jodi A. Mindell and Judith A. Owens; Lippincott Williams & Wilkins
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