Effects of a supportive care bundle on sleep variables of preterm infants during hospitalization

Abstract

Sleep is important for preterm infants' brain development, but they are frequently exposed to painful procedures in the neonatal intensive care unit (NICU) that disturb their sleep cycle and affect their growth. The purpose of this study was to examine the prolonged effects of a supportive care bundle (modulation of the infants' states, non-nutritive sucking, facilitated tucking, and oral sucrose feeding) on preterm infants' sleep variables (sleep efficiency, total sleep time, sleep latency, and frequency of wake bouts) during hospitalization. The team recruited 65 preterm infants (gestational age at birth 28-36 weeks, average birth weight 1,652 g) from a Level III NICU at a medical center in Taiwan. Infants were randomly assigned to one of two treatment conditions to be administered while receiving intrusive procedures: (1) control condition (usual care, including routine procedures, positioning, and gentle touch); or (2) intervention condition in which the supportive care bundle was added to usual care. Sleep variables were measured using actigraphy for a baseline of three continuous days on the 6th to 8th days after birth and again for 3 continuous days when infants weighed ≧1,950 g. Two forms of generalized estimating equation analyses with control of significant covariates were used for data analysis. The supportive care bundle not only significantly increased sleep efficiency and total sleep time but also significantly decreased duration of sleep latency and frequency of wake bouts. These results provide evidence to support the incorporation of the supportive care bundle into NICU clinical practice during intrusive procedures.

Effect of non-pharmacological interventions on sleep in preterm infants in the neonatal intensive care unit

“…Sleep is important for maintaining the homeostasis of the organism. [ 26 , 27 ] The sleep, growth development, recovery and prognosis of premature infants, whose systems are not yet fully developed, are often affected by their own complications, the disturbance of the NICU environment, and the stimulation of frequent pain. [ 28 – 30 ] Non-pharmacologic interventions have been well concerned because of their low adverse effects.…”

Promoção do sono em unidades de cuidados intensivos neonatais: scoping review

“…El sueño presenta un papel fundamental y preponderante en el crecimiento y desarrollo de los recién nacidos (RN) (1,2) . En concreto, reviste gran importancia para el desarrollo del sistema nervioso central, particularmente de las estructuras cerebrales, sistema sensorial y conductual, y por eso su preservación es crucial (1,(3)(4)(5)(6)(7) .…”

“…El ambiente en las UCIN es perturbador y nocivo para el sueño neonatal, dada la luminosidad intensa y prolongada, el ruido excesivo y las manipulaciones constantes derivadas de los procedimientos invasivos y dolorosos frecuentes (médicos y de enfermería), que se presentan como factores/estímulos estresantes e interruptores del sueño del RN (1)(2)(3)(4)(5)(6)(7)8) .…”

“…El mantenimiento del ciclo de sueño contribuye al mantenimiento de la plasticidad cerebral (7) . En este sentido, la privación del sueño en el RN presenta un impacto negativo sobre el desarrollo adecuado del sistema nervioso central (especialmente de los prematuros) (1,5) , pudiendo resultar en daños neurológicos y en efectos negativos para su crecimiento y desarrollo (1,4,5,7) , pudiendo, también, afectar negativamente su recuperación de salud (1,4) , llevando a un retraso en el alta hospitalaria y a alteraciones comportamentales en la edad adulta (3) .…”

How nursing science builds from global evidence

“…Notably, the 2018 best paper was from Taiwan. It reported a successful intervention, which was a supportive care bundle, to improve the sleep of preterm infants (Lan et al, ).…”