A qualitative study of sleep quality in children and their resident parents when in hospital

Abstract

Objective: Poor sleep quality impairs immune responses and pain tolerance, both key to recovery from acute illness. Hospitalised children and their co-sleeping parents also risk emotional lability and impaired coping skills when sleep-deprived. We aimed to study the experiences of children and parents during hospital admissions.

Design: Semi-structured interviews were conducted with parents within a week of their child's discharge. Questions explored parent and child sleep quality, factors contributing to this, perceived impact on day-time functioning and suggested improvements to ward sleep environment.

Setting: Southampton Children's Hospital, UK.

Patients: 17 co-sleeping parents of 16 children aged 3-12 years completed interviews. Children admitted for surgical procedures and those with established sleep disorders or nocturnal seizures were excluded.

Main outcome measures: Constant comparative methods identified themes within the data using a grounded theory approach.

Results: Parents reported that they, and to a lesser extent their children, experienced reduced sleep quality. Noise and light as well as ward schedules were identified as key factors disrupting sleep. Parents reported that lack of sleep caused difficulties with their own emotional regulation and that of their child, affecting daytime parent-child relationships. Furthermore, they reported a negative impact of sleep deprivation on decision-making about their child's medical care.

Conclusions: Parents identified poor sleep in hospital as a significant additional burden to their child's hospital admission. Importantly, they identified potential improvements to the ward sleep environment. Intervention studies that target modifiable, child-centred alterations to night-time ward culture are recommended, focusing on measurable child and parental outcomes.

Keywords: Environmental noise; Paediatric ward; Sleep quality; Sleep routine..