Children's sleep quality in hospital

Abstract

Background Wound healing and immunity are impaired by poor quality or inadequate sleep. Furthermore children and their parents are at risk of mood instability, lapses in attention and irritability when sleep deprived. It follows that optimising sleep for both children and resident parents is an important goal during a hospital admission. There has been no prior research to our knowledge of sleep quality in children9s medical wards compared with sleep quality at home. Methods Semi-structured interviews were conducted with a parent five days after their child9s discharge from hospital. Question stems sought to identify the quality of sleep the child and parent experienced during their stay, the factors which contributed to sleep quality, the impact the quality of sleep had on day-time functioning and suggestions for ways to improve the sleep environment. Analysis of interviews identified key themes, constant comparative methods were used to enable theoretical inferences to be drawn. Results Key themes from 17 parent interviews included: reduced sleep quality experienced by both parents and to a lesser extent children during hospital admission in comparison to home. Every parent interviewed identified noise levels as a significant contributory factor and all noted adverse effects on their ability to function during the day. The source of noise was from other patients, staff and monitoring equipment. The administration of medications and routine nursing observations also caused disruption throughout the night. Children had later bedtimes in hospital compared to home and visiting hours did not encourage early bedtimes. Conclusion Participants did not sleep as well in hospital as at home and reported that maintaining good sleep hygiene for their child was problematic. There are simple environmental factors which could be adapted to improve the hospital sleep environment. For example the timing of nursing care and drug administration, reducing the level of noise on the ward and dimming the lighting during the night. Intervention trials could usefully establish the benefit of such changes to child wellbeing and recovery, as well as parental wellbeing.