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Published on: June 30, 2014
Critically Ill Children Show Disrupted Sleep Patterns and Atypical Electroencephalograms: An Observational Cohort
Eris van Twist1, Arnout B G Cramer1, Sascha C A T Verbruggen1
1Division of Paediatric Intensive Care, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
Insights
Critically ill children experience significantly disrupted sleep, with reduced REM and deep sleep stages. Non-critically ill children also show sleep fragmentation, particularly in infancy and older age groups.
Area of Science:
- Pediatric critical care
- Sleep medicine
- Neurophysiology
Background:
- Sleep disruptions are prevalent in hospitalized children.
- Understanding sleep patterns is crucial for critically ill and non-critically ill pediatric patients.
Purpose of the Study:
- To describe and compare sleep characteristics in critically ill and non-critically ill hospitalized children.
- To investigate sleep in young infants and children with central nervous system injuries.
Main Methods:
- Observational cohort study comparing two groups: critically ill children (PICU, ≥48h stay) and non-critically ill children (suspected sleep disordered breathing).
- Sleep was measured using polysomnography.
- Data collected between 2017 and 2022, with comparisons to age-specific reference ranges.
Main Results:
- Critically ill children (n=25) had significantly reduced total sleep time (50.9%), with 96.0% showing reduced Rapid Eye Movement (REM) sleep and 66.7% reduced deep sleep.
- Electroencephalographic (EEG) abnormalities were frequent (76.0%) in critically ill children.
- Non-critically ill children (n=120) exhibited reduced REM sleep in infancy and fragmented sleep in older children.
Conclusions:
- Critically ill children demonstrate profoundly disrupted sleep architecture and atypical EEG findings.
- Non-critically ill hospitalized children primarily experience reduced and fragmented sleep patterns.
Aim:
Sleep disruptions are common in hospitalised children. This study described sleep in critically ill and non-critically ill hospitalised children, including young infants and patients with central nervous system injuries.
Methods:
This observational cohort study included two groups: critically ill children admitted to a paediatric intensive care unit with expected stay of ≥ 48 h, and non-critically ill children with suspected sleep disordered breathing. Critically ill children were recruited within two clinical studies conducted between 2020 and 2022. Non-critically ill children were recruited from a retrospective database spanning between 2017 and 2021. Sleep was measured using polysomnography and compared with age-specific reference ranges.
Results:
We included 25 critically ill and 120 non-critically ill children. Median ages were 3.6 (1.0-20.4) and 36.7 (6.1-107.7) months, respectively. In critically ill children, nighttime total sleep time accounted for only 50.9% (49.5-55.5) of 24 h sleep. Rapid eye movement (REM) and deep sleep were reduced in 96.0% and 66.7%, respectively. Electroencephalographic (EEG) abnormalities were common (76.0%). Non-critically ill children had reduced REM sleep in early infancy and shorter, fragmented sleep in older children.
Conclusion:
Critically ill children had disrupted sleep and atypical EEG, while non-critically ill children mainly had reduced fragmented sleep.
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