Reduced Overnight Vital Signs Improve Sleep in Hospitalized Children: A Nonrandomized Interventional Trial

Area of Science:

• Pediatric Hospital Medicine
• Sleep Science
• Patient Safety

Background:

• Hospitalized children often experience sleep disturbances due to frequent monitoring.
• Optimizing sleep is crucial for pediatric recovery and well-being.

Purpose of the Study:

• To evaluate the impact of eliminating overnight vital signs (VS) monitoring on sleep quality and duration in hospitalized children.
• To compare sleep outcomes between children with reduced VS monitoring and those receiving standard care.

Main Methods:

• A nonrandomized controlled study involving 109 children on medical-surgical units.
• Intervention group: Forwent VS measurement at 0000 and 0400.
• Outcomes measured via actigraphy and self-report, including total sleep time, wake status, and sleep disturbances.

Main Results:

• Children in the intervention group experienced 49.2 minutes longer total sleep time (P=.04).
• More children in the intervention group were asleep at 0700 (77% vs 55%, P=.03), with improved self-reported restfulness.
• No increase in adverse events such as unplanned ICU transfers or rapid response activations was observed.

Conclusions:

• Eliminating overnight VS monitoring in pediatric acute care settings increases sleep duration.
• This practice modification is safe and associated with improved subjective sleep quality for hospitalized children.
• Reducing routine monitoring may be a key strategy to enhance sleep in the hospital environment.