Factors Related to Sleep Duration and Night Waking in Hospitalized Infants with Cyanotic Congenital Heart Disease

Main Article Content

Porntiwa Sanpawut
Autchareeya Patoomwan
Jariya Wittayasooporn

Abstract

This study aims to describe factors related to sleep duration and night waking in infants aged 6–12 months old with cyanotic congenital heart disease (CCHD) who were admitted to a pediatric cardiology ward at a tertiary hospital between December 2019 and September 2021. Data were obtained using the Demographic Data Record Form, Sleep-related Factors Questionnaires (the severity of heart failure, temperament,and caregiving activity), and the Infants’ Sleep-wake States Record Form. The record forms were assessed using video recording of the infants during 24 hours, and the data were then analyzed using descriptive statistics, the Pearson product-moment correlation coefficient, and Spearman’s rho correlation. The results revealed that most hospitalized infants with CCHD had a mean total sleep duration during the 24 hours of 770.44 minutes. The average number of night waking was 14.26 times/night. According to the correlation analysis, the severity of heart failure did not show a statistically significant correlation with sleep duration or night waking. Temperament was moderately and significantly correlated with sleep duration but not with night waking. Caregiving activities were moderately and significantly correlated with sleep duration and night waking. These results demonstrate that nurses and healthcare professionals should be aware of sleep problems in infants with cyanotic congenital heart disease and plan interventions to manage sleep disturbance to ensure good sleep quality.
Keywords: Congenital heart disease in infants, Cyanotic congenital heart disease, Night waking, Sleep duration

Article Details

How to Cite
1.
Sanpawut P, Patoomwan A, Wittayasooporn J. Factors Related to Sleep Duration and Night Waking in Hospitalized Infants with Cyanotic Congenital Heart Disease. Nurs Res Inno J [Internet]. 2024 Apr. 19 [cited 2024 Jun. 20];30(1). Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/261886
Section
Research Articles

References

Bathory E, Tomopoulos S. Sleep regulation, physiology and development, sleep duration and patterns, and sleep hygiene in infants, toddlers, and preschool-age children.Curr Probl Pediatr Adolesc Health Care. 2017;47(2):29-42.

Cullen T, Thomas G, Wadley AJ, Myers T. The effects of a single night of complete and partial sleep deprivation on physical and cognitive performance: A Bayesian analysis.J Sports Sci. 2019;37(23): 2726-34.

Mindell JA, Lee C. Sleep, mood, and development in infants. Infant Behav Dev. 2015;41(Supplement C):102-7.

Hirshkowitz M, Whiton K, Albert SM, Alessi C, BruniO, DonCarlos L, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-3.

Bruni O, Baumgartner E, Sette S, Ancona M, Caso G, Di Cosimo ME, et al. Longitudinal study of sleep behavior in normal infants during the first year of life. J Clin Sleep Med. 2014;10(10):1119-27.

Burger P, Van den Ende E, Lukman W, Burchell GL, Steur LM, Merten H, et al. Sleep in hospitalized pediatric and adult patients–a systematic review and meta-analysis.Sleep Med X. 2022 Nov 5;4:100059. doi: 10.1016/j.sleepx.2022.100059. PMID: 36406659; PMCID:

PMC9672415.

Ykeda DS, Lorenzi-Filho G, Lopes AAB, Alves RSC.Sleep in infants with congenital heart disease. Clinics.2009;64(12):1205-10.

Fidler AL, Voorhees S, Zhou ES, Stacciarini J-M, FedeleทDA. A systematic review and proposed conceptual model of sleep disturbances during pediatric hospitalizations.Sleep. 2022;45(5):zsac038. doi: 10.1093/sleep/zsac038.

Thomas A, Chess S, Birch HG. The origin of personality.Sci Am. 1970;223(2):102-9.

Ednick M, Cohen AP, McPhail GL, Beebe D,Simakajornboon N, Amin RS. A review of the effects of sleep during the first year of life on cognitive, psychomotor,and temperament development. Sleep. 2009;32(11):1449-58.

Morales-Muñoz I, Nolvi S, Virta M, Karlsson H,Paavonen EJ, Karlsson L. The longitudinal associations between temperament and sleep during the first year of life.Infant Behav Dev.2020;61:101485. doi: 10.1016/j.infbeh.2020.101485.

Sorondo BM, Reeb-Sutherland BC. Associations between infant temperament, maternal stress, and infants’ sleep across the first year of life. Infant Behav Dev. 2015;39:131-5.

DeLeon CW, Karraker KH. Intrinsic and extrinsic factors associated with night waking in 9-month-old infants.Infant Behav Dev. 2007;30(4):596-605.

Hybschmann J, Topperzer MK, Gjærde LK, Born P,Mathiasen R, Sehested AM, et al. Sleep in hospitalized children and adolescents: a scoping review. Sleep Med Rev.2021;59:101496. doi: 10.1016/j.smrv.2021.101496.

Kryger MH, Avidan AY, Berry RB. Neurophysiology of sleep and wakefulness. In: Kryger MH, editor. Atlas of clinical sleep medicine. 2nd ed. Philadelphia: Elsevier Saunsers; 2013.

Pearse SG, Cowie MR. Sleep-disordered breathing in heart failure. Eur J Heart Fail. 2016;18(4):353-61.

Knappe S, Pfarr A-L, Petzoldt J, Härtling S, Martini J.Parental cognitions about sleep problems in infants: a systematic review. Front Psychiatry. 2020;11:554221.doi: 10.3389/fpsyt.2020. 554221.

Ngampiam R. Sleep pattern and sleep disturbance factors of 1 to 2 year old ill children in the general pediatric unit[master’s thesis]. [Bangkok]: Mahidol University; 2003.

Herbert AR, de Lima J, Fitzgerald DA, Seton C, Waters KA, Collins JJ. Exploratory study of sleeping patterns in children admitted to hospital. J Paediatr Child Health.2014;50(8):632-8.

Bisogni S, Chiarini I, Giusti F, Ciofi D, Poggi G, Festini F. Impact of hospitalization on the sleep patterns of newborns, infants and toddlers admitted to a pediatric ward:a cross-sectional study. Minerva Pediatr. 2015;67(3):209-17.

Stremler R, Micsinszki S, Adams S, Parshuram C,Pullenayegum E, Weiss SK. Objective sleep characteristics and factors associated with sleep duration and waking during pediatric hospitalization. JAMA Netw Open.2021;4(4):e213924. doi: 10.1001/jamanetworkopen.

3924.

Alomri RM, Kennedy GA, Wali SO, Alhejaili F, Robinson SR. Association between nocturnal activity of the sympathetic nervous system and cognitive dysfunction in obstructive sleep apnea. Sci Rep. 2021;11(1):1-11.

Kryger MH, Roth T, Dement WC. Principles and practice of sleep medicine. 5th ed. Philadelphia: W.B. Saunders; 2011.

Stopford E, Ravi K, Nayar V. The association of sleep disordered breathing with heart failure and other cardiovascular conditions. Cardiol Res Pract. 2013;2013:356280. doi: 10.1155/2013/356280.

Weinraub M, Bender RH, Friedman SL, Susman EJ, Knoke B, Bradley R, et al. Patterns of developmental change in infants’ nighttime sleep awakenings from 6 through 36 months of age. Dev Psychol. 2012;48(6):1511.

Charastong C. A Study of Sleep Pattern in Premature Infants [master’s thesis]. [Bangkok]: Mahidol University; 2001.

Parmelee AH, Stern E. Development state in infant. In:Carmine D. Clemente, Dominick P. Purpura, Florence E.Mayer, editors. Sleep and the maturing nervous system.London: Academic Press; 1972. p. 199-214.

St James-Roberts I, Roberts M, Hovish K, Owen C. Video evidence that London infants can resettle themselves back to sleep after waking in the night, as well as sleep for long periods, by 3 months of age. J Dev Behav Pediatr.2015;36(5):324.

Ross RD. Grading the graders of congestive heart failure in children. J Pediatr. 2001;138(5):618-20.

Carey WB, McDevitt SC. Revision of the infant temperament questionnaire. Pediatrics. 1978;61(5):735-9.

Tattinapanit Y. A study of temperament and socioeconomic status in relation to infant development at six months of age and mother’s reactive behavior to her infant [master’s thesis]. [Bangkok]: Chulalongkorn University; 1996. (in Thai)

Carey WB. A simplified method for measuring infant temperament. J Pediatr. 1970;77(2):188-94.

Erondu AI, Orlov NM, Peirce LB, Anderson SL,Chamberlain M, Hopkins K, et al. Characterizing pediatric inpatient sleep duration and disruptions. Sleep Med.2019;57:87-91.

Dixley A, Ball HL. The effect of swaddling on infant sleep and arousal: A systematic review and narrative synthesis.Front Pediatr. 2022;10:1000180. doi: 10.3389/fped.2022.1000180

Galland BC, Taylor BJ, Elder DE, Herbison P. Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Med Rev. 2012;16(3):213-22.

Chong SY, Chittleborough CR, Gregory T, Lynch JW,Smithers LG. How many infants are temperamentally difficult? Comparing norms from the Revised Infant Temperament Questionnaire to a population sample of UK infants. Infant Behav Dev. 2015;40:20-8.

Tratornpisudhikul P. A study of infant temperament and factor affecting it, at Children’s Hospital, Bangkok [master’s thesis]. [Bangkok]: Mahidol University; 1986. (in Thai)

Abuhammad S, Khraisat O, Joseph R, Al Khawaldeh A.Factors that predict infant temperament: a Jordanian study.J Pediatr Nurs. 2020;51:e45-e9.

Spruyt K, Aitken RJ, So K, Charlton M, Adamson TM,Horne RS. Relationship between sleep/wake patterns,temperament and overall development in term infants over the first year of life. Early Hum Dev. 2008;84(5):289-96.