Sleep quality and sleep duration of children during clinical admission in Emma Children*s Hospital, Amsterdam UMC

Sleep, both quality and duration, are important for health and for recovery
from illness. Children in the Netherlands spend about a million nights in the
hospital every year, while little is known about their sleep during clinical
admission. Self-reported studies using sleep diaries, sleep questionnaires and
parent interviews indicate shorter sleep time and reduced sleep quality for
both children and parents staying in the room while their child is admitted in
the hospital. However, self-reporting can be inaccurate. Earlier research in
children with cancer in the USA with objective measurements of children's sleep
by means of accelerometry showed a reduced sleep quality and duration compared
to the normal situation at home. There are therefore indications that
hospitalization reduces sleep quality and sleep duration, but this has not been
objectively determined in wider groups of patients in clinical pediatric
settings.

Noise from caregivers at work during night shifts can be a major cause of sleep
disorders in clinical pediatric departments. The WHO recommends that the
average noise levels in hospital departments at night are not higher than 30
decibels (dBA), with peak levels not higher than 45 dB. One of the few studies
on hospital noise levels showed> 45 dB measured for 85% of nights in general
children's departments in Portugal, but there are no comparisons available with
the child's usual sleeping environment at home.

Despite modern facilities with single or double patient rooms with rooming-in
facilities for parents, admission and stay in a nursing ward are accompanied by
many disruptions due to the night work of the staff.

An Acute Admission Department (AOA) was recently opened in the Emma Children's
Hospital of the UMC Amsterdam. As a rule, all new patients are admitted to this
ward during the first (max) 72 hours. This means that the discontinuity of
24-hour care is concentrated in this department. In addition, there are 3 other
departments where scheduled admissions take place and where admitted children
(at the AOA) are transferred if they have to stay in the hospital for more than
72 hours (about 30% of all admissions).

The aim of this study is to analyze (in)activity, sleep quality and sleep
duration of children during clinical admission in the Amsterdam UMC (Acute
Admission Unit and regular nursing wards) in comparison with the normal
situation at home.
Determinants of sleep duration and sleep quality during admission will be
assessed, such as noise levels at the bedside, severity of illness and
immobilisation, .

Prospective observational cohort study of children admitted to the AOA and
other nursing units at the Emma Children's Hospital, Amsterdam UMC.
Registration periods:
- 24-48 hours during a stay at the AOA
- 24-48 hours during the subsequent stay in the regular nursing ward
- 24-48 hours at home 4-6 weeks later

The burden for atients and their parents is (very) low. Application of the same
accelerometers in a group of> 200 healthy school children in the ABCD study,
directed by the same P.I. showed that the wearing of an accelerometer was very
well tolerated by these test subjects, the burden was very low and (therefore)
compliance was good.
Risk is nil..