Paediatric Sleep

Introduction

At Evelina London children’s sleep medicine department we care for children; from newborns to adolescents with a wide variety of sleep problems. Our service was established in 2000 and is one of the few comprehensive children’s sleep centres in the UK. We see more than 3,000 children each year in both our clinics and laboratories. As part of the Guy’s and St Thomas’ Lifespan Sleep Group, we can ensure young people move seamlessly to our adult services when they reach 16.

We provide clinical evaluation, diagnosis and management of children with all forms of sleep disorders. Sleep disorders treated by our staff include:

• sleep-disordered breathing
• sleep apnoea
• nightmares
• insomnia
• parasomnias
• narcolepsy
• circadian rhythm disorders.

The centre is one of the busiest in the UK providing a complete range of sleep evaluations, from simple diagnostics to complex sleep studies. Our four-bed facility and home testing facilities allow us to evaluate patients with any type of sleep disorder including complex sleep and seizure disorders. We also work closely with our colleagues in respiratory medicine to support the children’s long-term ventilation service.

The Evelina Sleep programme has been designed by our clinical leads to provide a unique development experience which enables visiting professionals to broaden their expertise and learn new skills that can be transferred back to their workplace. We are excited to deliver exclusive access to observe and work alongside our Evelina Hospital Sleep team, and to provide an opportunity for international professionals to gain insight into our Trust and the role that clinicians within this department play within the NHS. 

Programme aims

The programme is aimed at those who wish to extend their expertise in paediatric sleep in the UK. 

The programme aims to include: 

• Direct experience and exposure of ward rounds and clinics 
• Involvement with our leading research programme and clinical research meetings 
• Opportunities to attend and contribute in our multidisciplinary meetings 
• Regular clinical educational meetings 
• The opportunity to complete specialty projects and research 
• The chance to undertake hands on clinical practice. Please note that this is dependent on programme duration and previous experience (not for observers) 

Format

The sleep programme is delivered within the hospital workplace and it has been designed by our clinical leads to educate visitors in a range of complex and emergency cases through exposure to acute resuscitation and stabilisation on retrieval, ward rounds and internal education activities such as research meetings. 

The programme allows visitors to be fully integrated within the day to day service of our teams. We will also align visitors with supervisors from within the clinical team who will provide one to one support and ensure that all of the learning and development needs and expectations are met.

Who can apply

This programme is intended for non-U.K. consultants, registrars and senior AHPs. 

Visitors have the choice of applying for a hands-on attachment or observership programme. Those wishing to apply for a hands-on attachment must have GMC registration and NMC registration. You can apply for GMC registration directly through the main GMC website, alternatively The Royal College of Physicians run a medical training initiative which facilitates GMC registration and provides sponsorship for a Tier 5 visa. You can find out more about their Medical Training Initiative by visiting their website. NMC registration can be applied for via NMC website.

Programme duration

It is recommended that in order to get the most out of the Sleep programme, that visiting professionals undertake a hands-on attachment placement of at least 9 weeks. However, the programme’s duration can potentially be tailored to the specific learning requirements of those visiting the Trust.

Paediatric Sleep service

The sleep medicine department at Evelina London Children’s Hospital treats a number of conditions. 

Sleep-disordered breathing

• Snoring
  • Noisy breathing 
  • Sleeping with open mouth 
  • Obstructive sleep apnoea (difficulty breathing while asleep, blockage of airflow) 
  • Central sleep apnoea and hypoventilation (long pauses in breathing/under breathing in sleep). 

Sleeplessness (insomnia) 

• Resisting bedtime 
• Problems getting to sleep 
• Frequent night-time waking 
• Irregular sleep patterns 
• Trouble with naps 
• Sleep schedule abnormalities 
• Eidetic imagery (imaginary play or intense imagery). 

Sleepy teenagers

• Difficulty falling asleep or waking at the desired hour 
• Remaining awake for long hours at night and sleeping until late hours in the morning/afternoon on weekends. 
• Feeling sleepy during the daytime 
• Insufficient sleep or inconsistent sleep schedule. 

Excessive daytime sleepiness

• Idiopathic hypersomnia 
• Narcolepsy 
• Kleine-Levin syndrome. 

Parasomnias (unusual sudden night-time events)

• Confusional arousals and sleep terrors (incomplete waking, crying or screaming, thrashing, looking upset or frightened) 
• Sleepwalking and sleep talking (while only partly awake) 
• Complex cases with uncertainty about nocturnal seizures or parasomnias. 

Restless legs syndrome

• Periodic limb movements in sleep – leg or arm jerks every 20 to 60 seconds while asleep 
• Restless leg syndrome (RLS) – restlessness / unpleasant feelings in legs during the evening or at bedtime 

Advanced sleep workshop

This workshop runs around four to five times a year and is for children with behavioural insomnia and sleep association interventions. The workshop aims to provide psychological education on sleep. It includes a package of telephone support to help parents/carers undertake a behavioural intervention to address sleep difficulties in their child. Usually the parents that attend the workshop have children with a complex range of neurodevelopmental or medical needs. They may have already attempted behavioural interventions for sleep difficulties. 

Referrals are made to the advanced sleep workshop following initial assessment in the children’s sleep clinic. Referrals are usually made by our sleep consultants and occasionally external consultants. Groups of five to six parents/carers are seen together in the workshop. Psychoeducational information on sleep interventions for behavioural insomnia is given over three to four hours. After the workshop, we provide a package of telephone support to support parents/carers with behavioural interventions. Telephone support is predominantly undertaken by Theresa Ross, our sleep specialist health visitor. 

London Paediatric Sleep Group

The London Paediatric Sleep Group is made up of professionals from the different paediatric sleep centres within London and the south east, including: 

• Evelina London Children’s Hospital 
• Great Ormond Street Hospital for Children 
• The Royal Brompton Hospital 
• St Mary’s Hospital 
• The Royal London Hospital 
• St George’s Hospital
• Southampton Children’s Hospital 
• King’s College Hospital 

The group meets three times a year for an academic session relating to paediatric sleep medicine, with the host venue rotating between different sites. These meetings offer a regular opportunity for professionals from all disciplines working within paediatric sleep medicine to meet to: 

• discuss new developments and research 
• share complex clinical problems 
• agree common pathways for assessing and managing sleep problems, 
• discuss technical aspects of providing specialised services and investigations. 

The meetings are also an opportunity to meet other professionals working within this small sub-specialty of paediatrics. Meetings are coordinated by Dr Michael Farquhar at Evelina London Children’s Hospital, and usually occur in January, May and September of each year. 

Kids Sleep Dr app

With years of proprietary research and expertise Professor Paul Gringras, founder and head of the Sleep Medicine Department created the Kids Sleep Dr app; a sleep diary app that allows parents to understand their child’s sleep patterns, track their progress and receive personalised sleep tips.

Fees

A course fee per week will be applied; this fee excludes accommodation and travelling expenses. To find out the fee amount please email vpp@gstt.nhs.uk.

Please note

Clinicians are able to offer bursaries or discounted placements on an individual basis. This is at the discretion of the Directorates of GSTT and does not affect the terms and conditions of the Visiting Professional Programme agreements.