Sleep disruption and delirium in critically ill children: Study protocol feasibility

Area of Science:

• Pediatric Critical Care Medicine
• Sleep Science
• Neuroscience

Background:

• Delirium is a significant complication in critically ill children.
• Sleep disruption and circadian rhythm dysregulation are linked to delirium.
• The pediatric intensive care unit (PICU) environment presents numerous sleep-disrupting factors.

Purpose of the Study:

• To describe and evaluate the feasibility of a protocol for an observational pilot study.
• To measure the PICU environment (light, sound, caregiving), sleep, and delirium in critically ill children.
• To establish a measurement framework for future research and interventions.

Main Methods:

• Observational pilot study of 10 children aged 1-4 years in the PICU.
• Continuous bedside monitoring of light and sound exposure using sensors.
• Video recording to quantify caregiving and confirm sleep via actigraphy.
• Twice-daily delirium screening using the Cornell Assessment of Pediatric Delirium.

Main Results:

• The study protocol was evaluated for feasibility (acceptability, implementation, practicality).
• A comprehensive measurement framework was developed for assessing the PICU environment, sleep, and delirium.
• Continuous bedside data collection methods were refined.

Conclusions:

• The developed protocol is a feasible framework for studying the complex interplay of the PICU environment, sleep, and delirium.
• This research informs future large-scale studies and the development of sleep promotion interventions for critically ill children.
• Refined measurement strategies are crucial for advancing care in pediatric critical illness.