informed consent, fifty children admitted post-operatively to the PICU had actigraphy monitoring placed on post-operative day #1, with continuation of monitoring through hospital discharge. Results: Sleep was severely fragmented in the PICU with a lack of day-night cycle, with several awakenings during nighttime hours. Increased sleep fragmentation was associated with increased length of mechanical ventilation and exposure to sedatives and analgesics. The figure shows a representative actigraphy plot with several awakenings throughout the 24 hour periods of hospitalization-red underlined areas indicate periods of sleep.Conclusions: Children admitted to the PICU after major surgery experience severe sleep disturbances that may have important implications for outcomes. Future studies will investigate the effect of specific sedatives and analgesics on sleep-wake cycles as well as the role of non-pharmacologic sleep hygiene protocols to improve sleep during recovery.
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