Critically Ill Children Show Disrupted Sleep Patterns and Atypical Electroencephalograms: An Observational Cohort Study
Eris van Twist, Arnout B. G. Cramer, Sascha C. A. T. Verbruggen, Maartje Louter, Karlien Veldscholte, Koen F. M. Joosten, Matthijs de Hoog, Karla Biesheuvel, Dirk C. G. Straver, Rogier C. J. de JongeABSTRACT
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.