• Amanda B Hassinger, Kalgi Mody, Simon Li, Lauren K Flagg, FaustinoE Vincent SEVSDepartment of Pediatrics, Division of Pediatric Critical Care, Yale School of Medicine, Yale New Haven Children's Hospital, New Haven, CT., Sapna R Kudchadkar, and Ryan K Breuer.
• Department of Pediatrics, Division of Pulmonology and Sleep Medicine, University at Buffalo School of Medicine and Biomedical Sciences, John R. Oishei Children's Hospital, Buffalo, NY.
• Crit. Care Med. 2024 Nov 1; 52 (11): e578e588e578-e588.

ObjectivesSleep promotion bundles being tested in PICUs use elements adapted from adult bundles. As children may react differently than adults in ICU environments, this study investigated what parents report disrupted the sleep of their child in a PICU.DesignSecondary analysis of a multicenter validation study of the Survey of Sleep quality in the PICU.SettingFour Northeastern U.S. PICUs, one hospital-based pediatric sleep laboratory.PatientsParents sleeping at the bedside of a child in the PICU or hospital-based sleep laboratory.InterventionsAnonymous one-time survey eliciting parts of hospital or ICU environments that have been described as disruptive to sleep in validated adult ICU and pediatric inpatient questionnaires.Measurements And Main ResultsLevel of sleep disruption was scored by Likert scale, with higher scores indicating more disruption. Age, demographics, baseline sleep, and PICU exposures were used to describe causes of sleep disruption in a PICU. Of 152 PICU parents, 71% of their children's sleep was disrupted significantly by at least one aspect of being in the PICU. The most prevalent were "being in pain or uncomfortable because they are sick" (38%), "not sleeping at home" (30%), "alarms on machines" (28%), and "not sleeping on their home schedule" (26%). Only 5% were disrupted by excessive nocturnal light exposure. Overall sleep disruption was not different across four PICUs or in those receiving sedation. The validation study control group, healthy children undergoing polysomnography, had less sleep disruption than those in a PICU despite sleeping in a hospital-based sleep laboratory.ConclusionsThere are multiple aspects of critical care environments that affect the sleep of children, which are different from that of adults, such as disruption to home schedules. Future interventional sleep promotion bundles should include sedated children and could be applicable in multicenter settings.Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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