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BEARS screening tool for assessment of sleep in children

BEARS screening tool for assessment of sleep in children
  Preschool
(2 to 5 years)
School-aged
(6 to 12 years)
Adolescent
(13 to 18 years)
Bedtime problems

Does your child have any problems going to bed?

Falling asleep?

Does your child have any problems at bedtime? (P)

Do you have any problems going to bed? (C)
Do you have any problems falling asleep at bedtime? (C)
Excessive daytime sleepiness

Does your child seem overtired or sleepy a lot during the day?

Does your child still take naps?

Does your child have difficulty waking in the morning, seem sleepy during the day, or take naps? (P)

Do you feel tired a lot? (C)
Do you feel sleepy a lot during the day? In school? While driving? (C)
Awakenings during the night Does your child wake up a lot at night?

Does your child seem to wake up a lot at night? Any sleepwalking or nightmares? (P)

Do you wake up a lot at night? Have trouble getting back to sleep? (C)

Do you wake up a lot at night?

Have trouble getting back to sleep? (C)
Regularity and duration of sleep

Does your child have a regular bedtime and wake time?

What are they?

What time does your child go to bed and get up on school days? Weekends?

Do you think your child is getting enough sleep? (P)

What time do you usually go to bed on school nights?

Weekends? How much sleep do you usually get? (C)
Sleep-disordered breathing Does your child snore a lot or have difficulty breathing at night? Does your child have loud or nightly snoring or any breathing difficulties at night? (P) Does your teenager snore loudly or nightly? (P)

The BEARS instrument prompts screening questions in 5 major sleep domains, represented by the acronym BEARS: Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing. The table above shows examples of trigger questions for each age group.

The goal of the BEARS tool is to prompt the clinician to ask useful screening questions about sleep. Affirmative answers to these questions should be followed by further clinical evaluation focused on that sleep domain. BEARS is not a scored instrument and is not intended to diagnose specific sleep problems.
P: questions addressed to parent; C: questions addressed to child.
Reproduced with permission from Judith Owens, MD, MPH. Originally published in: Owens JA, Dalzell V. Use of the 'BEARS' sleep screening tool in a pediatric residents' continuity clinic: a pilot study. Sleep Med 2005; 6:63.
Graphic 94931 Version 4.0

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