Sick children lose more than an hour’s sleep per night on noisy hospital wards, according to new UK research, which suggests it could harm their recovery.
The study carried out at Southampton Children’s Hospital found the noise on paediatric medical wards exceeded the 30 decibel maximum recommended by the World Health Organization (WHO) and was significantly louder than in their bedrooms at home.
“When children lose sleep in hospital they have a lower pain threshold, are more emotional and may have lowered immune defences”
The findings suggest hospitals are failing to consider some of the fundamentals of good nursing set out by Florence Nightingale herself more than 150 years ago.
The nursing founder stated that “unnecessary noise is the cruellest absence of care”, highlighted study authors in their paper published in the journal Archives of Disease in Childhood.
Thy noted that this problem had come to light despite the fact that reducing noise at night in hospitals was key performance target for NHS trusts.
The study, led by Dr Catherine Hill, a consultant in paediatric sleep medicine, looked at the experiences of 46 children aged three to 16, and 16 mothers who also stayed on children’s wards.
The research team compared the length and quality of sleep they had in hospital compared to at home and also measured noise levels.
“This is the first time we have established the same situation on general medical wards”
The average sound level recorded on hospital wards was 48.24 decibels but reached 50.35 decibels for beds in open bays, significantly higher than the 30 decibels recommended by WHO – the equivalent to quiet conversation.
In contrast, average noise levels recorded in children’s bedrooms at home were 34.7 decibels.
The researchers found children were sleeping for 63 fewer minutes at night, while their mothers got nearly 73 minutes less sleep.
“Previous research has indicated children’s cancer and intensive care wards are noisy at night but this is the first time we have established the same situation on general medical wards,” said Dr Hill, who is also an associate professor in child health at the University of Southampton.
“When children lose sleep in hospital they have a lower pain threshold, are more emotional and may have lowered immune defences so this is an issue we need to address,” she noted.
Sleep loss may also compound the stress and anxiety parents feel at having a child in hospital, the study paper added.
“Despite 150 years of medical progress we have forgotten the basic lessons of patient care,” concluded the paper, which includes the quote from Florence Nightingale.
“Sleep is one aspect of care that can be freely delivered and future research should evaluate interventions which promote sleep for children and parents alike,” it said.
Dr Hill has previously spearheaded the launch of the UK’s first programme to improve the sleep environment for young patients and their parents, which is now being extended nationwide.
The Sleep for Health in Hospital (SHH) programme involves the introduction of an “eight is late” policy, which sees lights dimmed at 8pm and a flag raised on each ward to remind everyone about bedtime.
The scheme is now being rolled out nationwide by Dr Hill and colleagues through the Paediatric Innovation and Research Network, which sees her team provide training workshops for staff.
“The aim with SHH was to take healthy sleep in hospital for young patients beyond a list of recommendations to fundamental culture change and have a transferrable programme that could be adopted by children’s wards nationwide,” said Dr Hill.
“We are now at that stage so, hopefully, we can ensure all children and their parents will eventually be able to enjoy a suitable and comfortable sleep environment for the duration of their hospital admission,” she said.