Sleep Health in Critically Ill Children With Acute Respiratory Failure

BACKGROUND: Sleep health is an overlooked but important part of children's health and development. The health consequences associated with poor sleep health may impact recovery during critical illness. OBJECTIVE: Explore sleep health among children in the pediatric intensive care unit (PICU) receiving usual care or a nurse-led chronotherapeutic care bundle. METHODS: Secondary analysis of the RESTORE Resilience (R2) trial. Parent-reported baseline sleep health was compared with PICU sleep health, including compliance with baseline sleep behaviors, alertness levels, and actigraphy-based measures of sleep timing, efficiency, and duration. RESULTS: In 52 R2 participants (6 months to 17 years), 49 provided prehospital sleep data and 22/49 (45%) had atypical baseline sleep health. Participants had irregular PICU sleep behaviors and spent ≥ 25% of PICU days sedated. Children experienced little daytime activity consolidation and short, fragmented sleep episodes. Total sleep time was within 1 hour of baseline on 23 (11%) study days. There were few associations between baseline and PICU sleep health or between R2 bundle implementation and PICU sleep health. CONCLUSIONS: Critically ill children demonstrated disrupted sleep health. Results will inform nurse-led interventions to promote sleep in the PICU.