The Impact of Sleep Quality on Clinical Outcomes in Hospitalized Children: A Systematic Review
DOI:
https://doi.org/10.37287/ijghr.v8i4.2090Keywords:
clinical outcomes, hospitalization, hospitalized children, sleep quality, systematic reviewAbstract
Sleep is an essential physiological need in children that plays an important role in physical growth, neurological development, and the recovery process during illness. Hospitalized children are at high risk of experiencing sleep quality disturbances due to environmental, clinical, and psychological factors. Sleep disturbances during hospitalization are known to be associated with various adverse clinical outcomes. To identify the relationship between sleep quality and clinical outcomes in hospitalized children based on the latest scientific evidence. This systematic review was conducted in accordance with the PRISMA guidelines. Literature searches were performed in PubMed, ScienceDirect, Scopus, and Wiley. “poor sleep quality” AND “hospitalized children” AND “length of stay.” Included studies were quantitative studies involving hospitalized children aged 0–18 years that reported the relationship between sleep disturbances and clinical outcomes. Study quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist, and the findings were analyzed using narrative synthesis. A total of six studies years 2021-2026 met the inclusion criteria. All studies reported decreased sleep quality during hospitalization, characterized by reduced sleep duration, increased nighttime awakenings, and decreased sleep efficiency. Sleep disturbances were associated with slower recovery, increased psychological distress, and a potential increase in length of hospital stay. The main contributing factors include environmental noise, medical interventions, pain, and anxiety. Non-pharmacological interventions were found to be effective in improving sleep quality. Sleep quality disturbances are common and multifactorial problems among hospitalized children and have a significant impact on clinical outcomes. Optimizing sleep quality should be integrated into clinical practice through simple interventions and family-centered approaches.
References
Burger, P., Steur, L.M.H., Polderman, J.A.W., & Gemke, R.J.B.J. (2025). Sleep disturbances in hospitalized children: Comparison between acute admission and regular care units . Global Pediatrics, 11, 100237. https://doi.org/10.1016/j.gpeds.2024.100237
Burger, P., Steur, LMH, Polderman, JAW, Twisk, JWR, Lindeboom, R., & Gemke, RJBJ (2024). Sleep disturbances in hospitalized children: A wake-up call . European Journal of Pediatrics, 183, 4063–4072. https://doi.org/10.1007/s00431-024-05660-x
Burger, P., Van den Ende, ES, Lukman, W., Burchell, GL, Steur, LMH, Merten, H., Nanayakkara, PWB, & Gemke, RJBJ (2022). Sleep in hospitalized pediatric and adult patients: A systematic review and meta-analysis . Sleep Medicine :
Byeon, A.G., Weiss, S.K., Gilfoyle, E., & McKinnon, N.K. (2025). Sleep fragmentation in critically ill children: A review of contributing factors in the pediatric intensive care unit and neurodevelopmental outcomes . Frontiers in Sleep, 4, 1629408. https://doi.org/10.3389/frsle.2025.1629408
Fidler, A.L., Waitt, J., Lehmann, L.E., Solet, J.M., Duffy, J.F., Gonzalez, B.D., Beebe, D.W., Fedele, D.A., & Zhou, E.S. (2023). Sleep and circadian disruptors: Unhealthy noise and light levels for hospitalized pediatric patients. Journal of Hospital Medicine , 18(11), 999–1003.
Gemke, R. J. B. J., Burger, P., & Steur, L. M. H. (2025). Sleep disorders in children: Classification, evaluation, and management—A review . European Journal of Pediatrics, 184, 39. https://doi.org/10.1007/s00431-024-05822-x
Hassinger, A.B., Afzal, S., Rauthz, M., & Breuer, R.K. (2023). Pediatric intensive care unit-related sleep and circadian dysregulation: A focused review. Seminars in Pediatric Neurology , 48, 101077.
He, Y., Zhang, Y., Xin, H., Lin, J., Lin, S., Li, S., Cheng, X., Liu, G., & Liao, J. (2026). Effect of diary intervention on sleep quality and risk of stress disorders among critically ill children in pediatric intensive care units and on their parents' anxiety levels: A randomized controlled trial . Intensive & Critical Care Nursing, 93, 104315. https://doi.org/10.1016/j.iccn.2025.104315
Jacobson, J.L., Tylka, J., Glazer, S., Zhang, Y., Cosme, R., Silvestri, J.M., & Patwari, P.P. (2023). Melatonin use in pediatric intensive care units: A single-center experience . Medical Sciences, 11(3), 55. https://doi.org/10.3390/medsci11030055
Ji, K.-H., Kim, D.-K., Kim, E.-H., & Chung, S. (2025). The missing link in patient recovery: Hospital sleep medicine . Sleep Medicine Research, 16(1), 7–17. https://doi.org/10.17241/smr.2025.02782
Lechosa-Muñiz, C., Ruiz-Azcona, L., Belmonte, E. P., Paz-Zulueta, M., & Cabero-Pérez, M. J. (2024). Impact of an intervention aimed at improving sleep quality in hospitalized children . Children, 11, 848. https://doi.org/10.3390/children11070848
Riehm, J.M., Arora, V.M., Tatineni, S., Erondu, A., Mozer, C.L., Cook, D.J., Byron, M., Mordell, L., Ye, F., & Orlov, N.M. (2021). The impact of the COVID-19 pandemic on nighttime room entries and sleep disturbances for pediatric patients . Sleep Medicine, 84, 76–81. https://doi.org/10.1016/j.sleep.2021.05.020
Stremler, R., Micsinszki, S., Adams, S., Parshuram, C., Pullenayegum, E., & Weiss, S. K. (2021). Objective sleep characteristics and factors associated with sleep duration and waking during pediatric hospitalization. JAMA Network Open , 4(4), e213924.
Topsakal, S., & Ekici, B. (2022). Effect of illuminated musical mobile on sleep quality of children hospitalized in pediatric emergency departments . Journal of Pediatric Nursing, 67, e156–e164. https://doi.org/10.1016/j.pedn.2022.08.004
van der Perk, C.-J., Burger, P., Maaskant, J., & Gemke, R. J. B. J. (2024). Parents' experiences and perspectives of their child's sleep quality during hospitalization . Clinical Pediatrics, 63(6), 755–763. https://doi.org/10.1177/00099228231188223
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
