Sleep quality and factors that disturb sleep among infants and preschoolers admitted to two pediatric intensive care units in Norway.

PURPOSE

Sleep disturbances have potential consequences for critically ill children, and admission to the pediatric intensive care unit can entail numerous sleep-disturbing factors. This study aimed to investigate children's sleep quality in the pediatric intensive care unit and factors that disturb their sleep.

METHODS

An observational cross-sectional study, using sleep measurements involving actigraphy, noise measurements, and sleep diaries, was conducted in two PICUs in two locations at a large university hospital in Norway.

RESULTS

In total, 21 children from 5 months to 5 years were included in the study. The median 24-h total sleep time was 10.5 h. Participants exhibited severely fragmented sleep, with a median sleep efficiency of 68.8 % and a median wake after sleep onset of 216 min. The median equivalent continuous sound level was 55.79 dBA. Single rooms had significantly higher equivalent continuous sound levels than multi-bed rooms (p < 0.001). Participants had a median of nine observed awakenings, with healthcare personnel accounting for 44 %.

CONCLUSIONS

Overall, 63 % of participants slept below the recommended durations, and all patients had fragmented sleep and affected sleep-wake cycles. Although single rooms were generally quieter, they had significantly higher equivalent continuous sound pressure levels due to higher sound peaks. Healthcare personnel and procedures were the highest documented reasons for awakenings.

CLINICAL IMPLICATIONS

Based on the results of this study, it is evident that improving sleep quality should be considered a crucial clinical priority for children in the PICU. Minimizing disturbances caused by healthcare personnel and implementing interventions to reduce noise may improve children's sleep quality.