Are kids able to get enough sleep when hospitalized?

Being in the hospital can be a frightening experience for a child and that fear, along with environmental elements such as continual nose and light, could lead to poor sleep at a time when good sleep hygiene is so crucial. A report in JAMA Network Open looks into how the hospital environment can affect the sleep quality for children.¹

The prospective cross-sectional study included children who were admitted to a general pediatric unit or the pediatric intensive care unit at a teaching hospital from October 2007 to July 2008. The participants were children aged 1 to 18 years who had an expected hospital stay of at least 2 nights. The participant’s usual sleep habits, information about the reason for the hospital stay, and demographic data were collected from records. Each child wore an actigraph for 1 to 3 consecutive days and nights. They also completed a sleep diary. Sound and light were measured with meters placed at the child’s bedside.

A total of 69 children were included in the study. The average number of minutes of nighttime sleep for participants aged 1 to 3 years, 4 to 7 years, 8 to 12 years, and 13 to 18 years was 444 (132), 475 (86), 436 (114), and 384 (83) minutes of nighttime sleep, respectively, and the number of night awakenings was 14 (3), 18 (3), 14 (8), and 12 (6), respectively. Participants who were in the general pediatric unit slept about 258 minutes more per night than those who were in the pediatric intensive care unit (95% CI, 165.16-350.56 minutes; P < .001). Children who had been admitted for exacerbations of chronic illness got 123 minutes less sleep than those who had been admitted for planned surgery illness (95% CI, 49.23-196.01 minutes; P < .01). Shared rooms led to 141 minutes less sleep than being in a private room (95% CI, −253.51 to −28.35 minutes; P = .01). Increased risk of instantaneous waking was linked to a nurse in the room for most or all of the night (HR, 1.08; 95% CI, 1.03-1.13; P = .003), a sound event greater than 80 decibels (HR, 1.35; 95% CI, 1.02-1.80; P = .04), or a light event greater than 150 lux (HR, 1.17; 95% CI, 1.01-1.36; P = .03). Decreased risk of instantaneous waking was tied to sharing a room with another patient (HR, 0.78; 95% CI, 0.72-0.84; P < .001), being admitted for a planned surgery (HR, 0.95; 95% CI, 0.91-0.99; P = .04), and being in the general pediatric unit (HR, 0.81; 95% CI, 0.77-0.85; P < .001).

The investigators concluded that children who are hospitalized have significant nighttime waking and restricted sleep, indicating that many get less than the recommended amount a sleep. Clinicians should advocate for solutions that reduce excessive nighttime light and noise exposures in hospitals.

Reference

1. Drouin O, Sato R, Drehmer J et al. Cost-effectiveness of a smoking cessation intervention for parents in pediatric primary care. JAMA Netw Open. 2021;4(4):e213927. doi:10.1001/jamanetworkopen.2021.3927