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Correlation of Premature Infant Sleep/Wakefulness and Noise Levels in the Presence or Absence of "Quiet Time"
Raiani Roberta Pugliesi1, Michelle Siqueira Campillos, Kelly Cristina Sbampato Calado Orsi
1Nursing School, Universidade Federal de São Paulo, São Paulo, Brazil (Mss Pugliesi, Campillos, and Orsi and Drs Avena, Avelar, and Pinheiro); Associação Fundo de Incentivo à Pesquisa, Instituto do Sono, São Paulo, Brazil (Dr Pradella-Hallinan); and Department of Biostatistics, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil (Dr Tsunemi).
Insights
Implementing quiet time in neonatal units significantly increases total sleep time for premature infants. This nursing intervention also reduces noise levels, promoting better infant development and well-being.
Area of Science:
- Neonatal care
- Pediatric sleep science
- Nursing interventions
Background:
- Hospitalized infants, particularly premature neonates, are vulnerable to noise disruptions during sleep.
- High sound levels can negatively impact infant development.
- Quiet time is a strategy to mitigate noise and promote sleep in neonatal intensive care units.
Purpose of the Study:
- To assess the effectiveness of quiet time in reducing ambient sound levels.
- To determine the impact of quiet time on the total sleep duration of premature infants.
Main Methods:
- A longitudinal study involving 12 premature infants in a neonatal intermediate care unit.
- Implementation of four 60-minute quiet time periods daily.
- Evaluation of sleep-awake states using polysomnography and sound levels via a noise dosimeter before, during, and after quiet time.
Main Results:
- Total sleep time was significantly higher during quiet time periods (P = .005).
- A significant reduction in sound levels was observed during quiet time compared to other periods (P = .006).
- Infants showed longer periods of wakefulness following quiet time (P = .005).
Conclusions:
- Quiet time is an effective nursing intervention for improving sleep in neonatal units.
- The findings support the widespread implementation of quiet time in neonatal care settings.
- Further research with larger sample sizes is recommended to explore other sleep-influencing factors.
Background:
Peak sound levels during sleep can compromise the development of hospitalized infants. Quiet time is a strategy implemented in neonatal units to promote the sleeping of neonates by reducing noise levels, luminosity, and handling during particular periods of the day.
Purpose:
To determine the impact of quiet time on reducing sound levels and increasing total sleep time.
Methods:
This longitudinal study was conducted at a neonatal intermediate care unit with a convenience sample of 12 premature infants. Four times per day, 60-minute quiet times were provided in the neonatal unit. Sleep-awake states and sound levels were evaluated during quiet times as well as 60 minutes before and afterward. Polysomnography was used for sleep-awake state assessment, and a noise dosimeter was used to check sound levels every 24 hours.
Results:
The preterm infants had a corrected gestational age of 35.0 ± 1.5 weeks and weighed 1606.0 ± 317.8 g. Total sleep time was highest during quiet time (P = .005). Premature infants remained awake for longer following quiet times (P = .005). There was also a reduction in sound level during quiet times compared with the other time frames (P = .006). No statistically significant relationship was found between total sleep time and sound levels more than 24 hours.
Implications For Practice:
Quiet time is a nursing intervention that should be implemented in all neonatal units.
Implications For Research:
Future research should use a greater sample size and other factors that influence sleep should be further investigated.