Related Experiment Video
Updated: Jul 19, 2025
Measuring Neural Mechanisms Underlying Sleep-Dependent Memory Consolidation During Naps in Early Childhood
Published on: October 2, 2019
An observational pilot study of sleep disruption and delirium in critically ill children
Laura Beth Kalvas1, Tondi M Harrison2, Martha A Q Curley3
1The Ohio State University Center for Clinical and Translational Science, 236A Newton Hall, 333 W. 10th Ave., Columbus, OH, 43210, USA.
Insights
Pediatric intensive care unit (PICU) environments disrupt children's sleep. Increased clinician care frequency and duration are linked to poorer sleep quality and more delirium in children.
Area of Science:
- Pediatric critical care medicine
- Sleep science
- Environmental health
Background:
- Sleep disruption is common in children within the pediatric intensive care unit (PICU).
- Delirium is a frequent complication in critically ill children.
Purpose of the Study:
- To explore relationships between the PICU environment (light, sound, caregiver activity), sleep disruption, and delirium in children.
- To identify modifiable factors in the PICU that may impact sleep and delirium.
Main Methods:
- An observational pilot study involving ten children (1-4 years old) admitted to the PICU.
- Measurement of light, sound, and clinician caregiving patterns using bedside equipment.
- Assessment of sleep via actigraphy and delirium screening twice daily.
Main Results:
- Children experienced low daytime light, frequent excessive sound peaks, and frequent clinician caregiving.
- Sleep was characterized by frequent awakenings and short sleep episode durations.
- Children with delirium had worse sleep quality, with more awakenings and shorter sleep episodes, particularly during night shifts.
Conclusions:
- Findings suggest that increased clinician care frequency and duration are associated with poorer sleep quality and increased delirium in pediatric ICU patients.
- Results will guide future research and the development of nurse-driven interventions to promote sleep in the PICU.
Background:
Sleep disruption is frequently observed in children with delirium in the pediatric intensive care unit (PICU).
Objectives:
This observational pilot study explores relationships among modifiable characteristics of the PICU environment (i.e., light, sound, clinician caregiving patterns), sleep disruption, and delirium.
Methods:
Ten children, 1 to 4 years old, were recruited within 48 h of PICU admission and followed until discharge. A light meter, dosimeter, and video camera were placed at bedside to measure PICU environmental exposures. Sleep was measured via actigraphy. Twice daily delirium screening was conducted. Descriptive statistics were used to describe the PICU environment, sleep, and delirium experienced by children. Bivariate analyses were performed to determine relationships among variables.
Results:
Average participant age was 21 (SD = 9.6) months. Eight (80%) were admitted for respiratory failure. Median PICU length of stay was 36.7 (IQR[29.6, 51.5]) hours, which limited data collection duration. Delirium prevalence was 60% (n = 6). Children experienced low daytime light levels (x¯ = 112.8 lux, SD = 145.5) and frequent peaks (x¯ = 1.9/hr, SD = 0.5) of excessive sound (i.e., ≥ 45 A-weighted decibels). Clinician caregiving episodes were frequent (x¯ = 4.5/hr, SD = 2.6). Children experienced 7.3 (SD = 2.1) awakenings per hour of sleep and a median sleep episode duration of 1.4 (IQR[0.6, 2.3]) hours. On average, children with delirium experienced 1.1 more awakenings per sleep hour and 42 fewer minutes of sleep per sleep episode during the night shift. Increased clinician care frequency and duration were associated with worse sleep quality and delirium.
Conclusions:
Study results will inform future, large-scale research and nurse-driven sleep promotion interventions.
Related Concept Videos
01:13Insufficient Sleep and Sleep Deprivation
Sleep deprivation is a more severe form of sleep loss...
01:15REM Sleep Behavior Disorder
RBD is significantly associated with...