Sleep of 1- and 2-year-old children in intensive care.
Sleep of 1- and 2-year-old children in intensive care.
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DOI：
10.3109/01460869609026852
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发表时间：
1996-01-01
期刊：
影响因子：
--
通讯作者：
Corser, N C
中科院分区：
文献类型：
--
作者：
Corser, N C
与睡眠障碍相关的生理和心理变化降低了危重儿童适应住院的能力，从而阻碍了康复。研究表明，重症监护环境会干扰成年人的睡眠，但人们对这些环境对儿童睡眠的影响知之甚少。一项探索性现场研究描述了1岁和2岁重症监护儿童的睡眠-觉醒模式，确定了与睡眠和觉醒状态相关的重症监护环境刺激，比较了重症监护睡眠-觉醒模式和患病前的睡眠-唤醒模式，并确定了儿童恢复到患病前的睡眠-唤醒模式所需的时间。12名年龄在13到35个月之间的儿童组成了这项研究的样本。测量了患病前和出院后的睡眠模式，儿科重症监护病房(PICU)12小时夜间的睡眠模式，以及外部和内部环境刺激。在住院之前，受试者表现出与健康儿童记录的睡眠类似的睡眠。PICU中的儿童经历了严重的睡眠不足、频繁的觉醒和虚拟的快速眼动(REM)睡眠剥夺。光、噪声、照顾者活动等外部环境刺激与睡眠状态呈负相关。疼痛和苯二氮卓类药物治疗与睡眠获得有关。在PICU和医院出院后，睡眠变化持续存在。总睡眠时间比夜间觉醒恢复得更快。父母认为，他们的孩子的睡眠时间比总睡眠时间和夜间觉醒值显示的时间更长。
Physiologic and psychologic changes associated with sleep disturbance decrease the ability of a critically ill child to adapt to hospitalization and thus hamper recovery. Research demonstrates that intensive care settings interfere with sleep of adults, but little is known about the impact of these settings on children's sleep. An exploratory field study was conducted to describe the sleep-wake patterns of 1- and 2-year-old children in intensive care, identify intensive care environmental stimuli associated with sleep and waking states, compare the intensive care sleep-wake pattern to the pre-illness sleep-wake pattern, and determine the time required for children to return to their pre-illness sleep-wake pattern. Twelve children aged 13 to 35 months composed the sample for the study. Pre-illness and postdischarge sleep patterns, sleep patterns during a 12-hour night in the pediatric intensive care unit (PICU), and external and internal environmental stimuli were measured. Prior to hospitalization, subjects demonstrated sleep similar to that documented in healthy children. Children in the PICU experienced a significant loss of sleep, frequent awakenings, and a virtual rapid eye movement (REM) sleep deprivation. External environmental stimuli of light, noise, and caregiver activity were negatively correlated with sleep state. Pain and treatment with benzodiazepines were associated with sleep acquisition. Sleep changes persisted after discharge from the PICU and the hospital. Total sleep time recovered more rapidly than nighttime awakening. Parents perceived that their child's sleep remained different longer than total sleep time and night awakening values demonstrated.