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Published on: August 19, 2020
Sleep in the Hospitalized Child: A Contemporary Review
Jessica Berger1, Munfarid Zaidi1, Irene Halferty2
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Insights
Hospitalization disrupts children's sleep, impacting recovery and cognitive function. Non-pharmacologic interventions are crucial for promoting healthy sleep patterns in pediatric patients.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
- Hospital Medicine
Background:
- Acute illness and hospitalization present significant risks for sleep disruption in children.
- Poor sleep quality can impede recovery, healing, and long-term cognitive and executive functions.
- Hospital environments are often not conducive to promoting pediatric sleep.
Purpose of the Study:
- To review the current understanding of healthy sleep in children.
- To identify risk factors for sleep disturbances in hospitalized children.
- To explore non-pharmacologic interventions for optimizing sleep-wake patterns in pediatric inpatients.
Main Methods:
- Literature review of pediatric sleep.
- Analysis of risk factors for sleep disruption in hospital settings.
- Examination of sleep measurement tools and non-pharmacologic interventions.
Main Results:
- Pharmacologic interventions for sleep in hospitals have limited evidence and may negatively impact sleep.
- Non-pharmacologic strategies are considered high-yield for this vulnerable population.
- Understanding healthy sleep is foundational to addressing disruptions.
Conclusions:
- Optimizing sleep-wake patterns through non-pharmacologic means is essential for hospitalized children.
- Further research is needed to support evidence-based sleep interventions in pediatric inpatient care.
- Addressing sleep disruption is critical for neurocognitive development in pediatric patients.
Abstract:
Acute illness and hospitalization introduce several risk factors for sleep disruption in children that can negatively affect recovery and healing and potentially compromise long-term cognition and executive function. The hospital setting is not optimized for pediatric sleep promotion, and many of the pharmacologic interventions intended to promote sleep in the hospital actually may have deleterious effects on sleep quality and quantity. To date, evidence to support pharmacologic sleep promotion in the pediatric inpatient setting is sparse. Therefore, nonpharmacologic interventions to optimize sleep-wake patterns are of highest yield in a vulnerable population of patients undergoing active neurocognitive development. In this review, we briefly examine what is known about healthy sleep in children and describe risk factors for sleep disturbances, available sleep measurement tools, and potential interventions for sleep promotion in the pediatric inpatient setting.
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