PICU-related Sleep and Circadian Dysregulation Pilot Study

NCT ID: NCT06505447

Last Updated: 2025-06-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-06

Study Completion Date

2026-01-01

Brief Summary

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A single center pilot trial investigating the feasibility of using actigraphy and salivary melatonin levels to measure the sleep and circadian rhythm of critically ill children aged 3 to 6 years old. This study will also measure the feasibility of providing daytime light exposure as well as restricting all provided nutrition to during daytime hours.

Detailed Description

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Several of the identified sleep disruptors in a pediatric intensive care environment may not be modifiable, including restricting feeding to daytime hours and providing normal daytime light exposure. This study aims to measure the feasibility of measuring sleep and circadian patterns in a PICU during routine care and during 2 focused sleep promotion interventions: timed daytime light exposure (DLE) and daytime feeding restriction (DFR). The overall objective of this study is to test the hypothesis that, with multi-disciplinary efforts, providing chronotherapeutic care will be feasible and that reliably measuring sleep patterns and the CR of critically ill children with timed salivary melatonin assays and actigraphy is possible.

Conditions

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Circadian Dysrhythmia Sleep Disturbance Critical Illness Children, Only

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Three phase single center pilot study
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Phase 1: standard of care

10 children will be enrolled in the first phase related to determining if using actigraphy and timed saliva melatonin samples can be a feasible way to measure the sleep and circadian rhythm of critically ill children aged 3 to 6 years old while they receive routine critical care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Phase 2: Daytime light exposure

10 children will undergo the same sleep monitoring and salivary melatonin sampling as phase 1 while receiving timed exposure to a light box of 10,000 lux within 3 feet of their hospital bed for PICU days #2, 3 and 4.

Group Type EXPERIMENTAL

Daytime light exposure

Intervention Type OTHER

Participants will be exposed to a 10,000 lux light source within 3 feet of their face/eyes to promote the natural circadian rhythm for 2-3 hours from 10am to 12/1pm depending on their nap time at home

Phase 3: Daytime restricted feeding

10 children will undergo the same sleep monitoring and salivary melatonin sampling as phase 1 while attempting to limit all nutrition (parental or enteral) to being provided during the normal hours that the child is awake at home on PICU days #2, 3, 4.

Group Type EXPERIMENTAL

Daytime restricted feeding

Intervention Type OTHER

Participant's nutrition, parenteral or enteral, will be restricted to the hours when they are normally awake at home.

Interventions

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Daytime light exposure

Participants will be exposed to a 10,000 lux light source within 3 feet of their face/eyes to promote the natural circadian rhythm for 2-3 hours from 10am to 12/1pm depending on their nap time at home

Intervention Type OTHER

Daytime restricted feeding

Participant's nutrition, parenteral or enteral, will be restricted to the hours when they are normally awake at home.

Intervention Type OTHER

Other Intervention Names

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Light therapy

Eligibility Criteria

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Inclusion Criteria

1. Child age 3 to 6 years old on the day of PICU admission
2. English-speaking parent at the bedside
3. Child expected to remain in the PICU over 24 to 48 hours

Exclusion Criteria

1. Child is in end-of-life care
2. The child is receiving neuromuscular blockade for any reason
3. Caregiver or parent not at the bedside
Minimum Eligible Age

3 Years

Maximum Eligible Age

6 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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State University of New York at Buffalo

OTHER

Sponsor Role lead

Responsible Party

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Amanda B. Hassinger

Clinical Associate Professor of Pediatric Sleep Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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John R. Oishei Children's Hospital

Buffalo, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Amanda B Hassinger, MD

Role: CONTACT

716-323-0158

Haiping Qiao, MS

Role: CONTACT

716-323-0055

Facility Contacts

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Amanda B Hassinger, MD, MSc

Role: primary

716-323-0370

Haiping Qiao

Role: backup

716-323-0055

References

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Traube C, Silver G, Gerber LM, Kaur S, Mauer EA, Kerson A, Joyce C, Greenwald BM. Delirium and Mortality in Critically Ill Children: Epidemiology and Outcomes of Pediatric Delirium. Crit Care Med. 2017 May;45(5):891-898. doi: 10.1097/CCM.0000000000002324.

Reference Type BACKGROUND
PMID: 28288026 (View on PubMed)

Kamdar BB, Kamdar BB, Needham DM. Bundling sleep promotion with delirium prevention: ready for prime time? Anaesthesia. 2014 Jun;69(6):527-31. doi: 10.1111/anae.12686. No abstract available.

Reference Type BACKGROUND
PMID: 24813131 (View on PubMed)

Kudchadkar SR, Aljohani OA, Punjabi NM. Sleep of critically ill children in the pediatric intensive care unit: a systematic review. Sleep Med Rev. 2014 Apr;18(2):103-10. doi: 10.1016/j.smrv.2013.02.002. Epub 2013 May 21.

Reference Type BACKGROUND
PMID: 23702219 (View on PubMed)

Pun BT, Balas MC, Barnes-Daly MA, Thompson JL, Aldrich JM, Barr J, Byrum D, Carson SS, Devlin JW, Engel HJ, Esbrook CL, Hargett KD, Harmon L, Hielsberg C, Jackson JC, Kelly TL, Kumar V, Millner L, Morse A, Perme CS, Posa PJ, Puntillo KA, Schweickert WD, Stollings JL, Tan A, D'Agostino McGowan L, Ely EW. Caring for Critically Ill Patients with the ABCDEF Bundle: Results of the ICU Liberation Collaborative in Over 15,000 Adults. Crit Care Med. 2019 Jan;47(1):3-14. doi: 10.1097/CCM.0000000000003482.

Reference Type BACKGROUND
PMID: 30339549 (View on PubMed)

Berger J, Zaidi M, Halferty I, Kudchadkar SR. Sleep in the Hospitalized Child: A Contemporary Review. Chest. 2021 Sep;160(3):1064-1074. doi: 10.1016/j.chest.2021.04.024. Epub 2021 Apr 22.

Reference Type BACKGROUND
PMID: 33895129 (View on PubMed)

Hassinger AB, Mody K, Gomez R, Wrotniak BH, Falkowski K, Breuer R, Mennie C, Flagg LK. Validation of the Survey of Sleep Quality in the Pediatric Intensive Care Unit (SSqPICU). J Clin Sleep Med. 2024 Aug 1;20(8):1251-1258. doi: 10.5664/jcsm.11116.

Reference Type BACKGROUND
PMID: 38456806 (View on PubMed)

Other Identifiers

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STUDY ID#00008586

Identifier Type: -

Identifier Source: org_study_id

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