Exploring the Effect of Nightly Infusion Pump Alarms on Sleep in the Hospital

Frequent infusion pump alarms at night do not appear to significantly affect sleep quantity or satisfaction in pediatric cancer patients and their parents, despite reported poor sleep quality.

Summary and findings

This study measured sleep quantity, satisfaction, and quality in pediatric cancer patients and their parents in relation to nightly infusion pump alarms. Nineteen children (age 8.8 ± 4.9 years) and 30 parents (age 41.1 ± 6.3 years) participated, with alarms sounding a median of 3 times for parents and 5 times for children. No significant relationship was found between alarm frequency and sleep metrics.

Abstract

<title>Abstract</title> <p>Purpose Optimal sleep helps parents and children cope with life-threatening disease. However, hospital-surroundings are noisy, negatively affecting sleep quality and quantity. We aimed to determine sleep quantity; sleep satisfaction; their relation to infusionpump alarms in pediatric cancer patients and parents; and sleep quality and daytime impairment in parents. Methods Patients (2–18 years), admitted for scheduled anti-cancer therapy were eligible, as were inrooming parents. Frequency and duration of nightly infusion pump alarms were recorded. Patients and parents wore an accelerometer to assess sleep quantity (sleep efficiency, wake after sleep onset, night awakenings), additionally daily sleep satisfaction was assessed. Parents filled out questionnaires on sleep quality (PROMIS Sleep Disturbance, Insomnia Severity Index) and daytime impairment (PROMIS Sleep-Related Impairment, PROMIS Fatigue). Sleep quality scores were compared to norms. In children and parents the relation between alarms and sleep was assessed using multilevel analyses. Results Nineteen children (age 8.8 ± 4.9 years, 40 nights) and 30 parents (age 41.1 ± 6.3, 46 nights) participated (response 78%). Nightly alarms sounded median 3 times / 6 minutes in parents and 5 times / 10 minutes in children. Parents scored worse than the norm on sleep disturbances (P .01), but not on daytime impairment, 16% experienced clinical insomnia. There was no relation between alarms and sleep quantity or satisfaction for children and parents. Conclusions This explorative study showed that alarms sound frequently at night and parents sleep poorly during admissions. However, sleep of children and parents and alarms were not significantly related here. Future research should identify and improve (other) disrupting factors in the hospital.</p>

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