Critically Ill Children Show Disrupted Sleep Patterns and Atypical Electroencephalograms: An Observational Cohort Study

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.