Thread by @GasBugZa

Final paeds session is by Prof Brenda Morrow on 'Sleep - the Final Frontier'
#CCSSA2022 #critcare #FOAMcc

Sleep is critical to normal health, and children need much more sleep than adults. Circadian rhythms are established as early as two months of age.
doi.org/10.1038/497S2a
doi.org/10.2147/NSS.S6…
#CCSSA2022

Sleep deprivation in healthy children has clear deleterious acute and long term effects.
#CCSSA2022

In critically ill children, sleep is completely disrupted, but is not prioritised as a clinical outcome. Yet, lack of sleep has been shown to impair immune function, cause delirium, etc...
doi.org/10.1016/j.smrv…
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Use of benzodiazepines has been shown to decrease slow wave sleep and REM sleep, and disrupt the circadian rhythm. Their use is recommended to be minimised in recent guidelines.
doi.org/10.1097/PCC.00…
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Dexmedetomidine (my favourite) has far fewer effects on disrupting sleep structure, and is preferred.
#CCSSA2022

Environmental changes that can be used to help promote normal sleep include:
-minimising noise, esp at night
-allowing access to natural light
-eag plugs and eye covers at night
-activity (ie physio) during the day
#CCSSA2022