TL;DR

• The BEARS acronym stands for Bedtime Issues, Excessive Daytime Sleepiness, Night Awakenings, Regularity and Duration of Sleep, and Snoring.
• It is a simple, user-friendly tool designed to screen for sleep problems in children.
• The BEARS tool significantly increases the recording of sleep-related information and the identification of sleep problems in clinical settings.
• It is reliable and valid across different languages and settings, including Persian and ADHD populations.
• The tool is quick to administer, making it practical for use in primary care and neuropsychological assessments.

What Does BEARS Stand For? 🐻

The BEARS acronym is a pediatric sleep screening tool designed to identify sleep problems in children. Each letter in BEARS represents a specific domain of sleep-related issues:

• B: Bedtime Issues
• E: Excessive Daytime Sleepiness
• A: Night Awakenings
• R: Regularity and Duration of Sleep
• S: Snoring

This tool is used in primary care settings to quickly assess potential sleep problems by asking parents about these five domains. A "yes" response in any domain prompts further inquiry into the frequency and nature of the problem.

How Effective is the BEARS Tool? 📊

The BEARS tool has been shown to significantly increase the recording of sleep-related information and the identification of sleep problems in clinical settings. In a study conducted in a pediatric residents' continuity clinic, the use of BEARS resulted in a higher likelihood of documenting sleep issues compared to pre-BEARS visits. Specifically, information about bedtime issues, excessive daytime sleepiness, snoring, nighttime awakenings, and regularity and duration of sleep was more frequently recorded.

Table: Effectiveness of BEARS in Identifying Sleep Problems

The table above illustrates the significant increase in documentation of sleep-related issues when using the BEARS tool.

Is the BEARS Tool Reliable and Valid? ✅

The BEARS tool has demonstrated reliability and validity in various settings. A study on the Persian version of the BEARS questionnaire found it to be a reliable and relatively valid tool for screening pediatric sleep problems. The tool showed good to excellent test-retest reliability, particularly in preschool-aged children, and was valid for approximately half of the items in both preschool and primary school age groups.

How is BEARS Used in ADHD Populations? 🧠

In children with ADHD, sleep problems are prevalent, with estimates ranging from 25% to 50%. The BEARS tool has been shown to be a sensitive screener for sleep problems in this population. A study demonstrated that the BEARS tool has excellent diagnostic utility, with high sensitivity and specificity in identifying sleep problems in children with ADHD. This makes it a practical tool for clinicians conducting neuropsychological assessments.

What are the Applications of BEARS in Behavioral Insomnia? 🌙

Behavioral insomnia in infants and young children often presents as bedtime problems and night waking. The BEARS tool, along with a comprehensive sleep history and sleep diary, is useful for diagnosing these sleep problems. Behavioral therapies, such as extinction and bedtime fading, have shown significant improvements in sleep-onset latency and night waking frequency. Educating parents about sleep hygiene and bedtime routines is also crucial for treatment.

Conclusion

In summary, the BEARS acronym is a valuable tool for screening pediatric sleep problems. It is effective, reliable, and applicable across various settings and populations, including those with ADHD and behavioral insomnia. Its ease of use and quick administration make it an essential component of pediatric sleep assessments.