The Use of Melatonin by Children: Parents' Perspectives.

STUDY OBJECTIVES: To explore the perceptions and experiences of parents whose children were using melatonin. METHODS: A qualitative exploratory study was undertaken using face-to-face semi-structured interviews that were audio recorded and transcribed verbatim. Data was thematically analyzed via open coding and subsequent axial coding. Data collection continued until theoretical saturation occurred. RESULTS: Eleven interviews with parents of children with a neurodevelopmental disorder were conducted. Each parent perceived melatonin as effective in alleviating their child's sleep disturbance, and in restoring family functioning after many years of hardship and stress. The perceived "naturalness" of melatonin was valued by participants, who tended to favor it over other medications prescribed for sleep. The cost of melatonin was also commented on by every participant; however, all perceived the benefits of melatonin for the child and the family to outweigh the cost burden. When discussing the future, some parents were unsure of whether their child would still be using melatonin; however, others were happy for their child to continue melatonin indefinitely. In addition, many parents expressed a desire for prescribers to have greater knowledge about melatonin, and to acknowledge the positive impact melatonin had had on their lives. CONCLUSIONS: Parents perceive melatonin to be effective in alleviating their child's sleep disturbance and in improving their behavior, as well as restoring family functioning.

Benefits of quiet time for neuro-intensive care patients.

The primary mission of any intensive care unit (ICU) is to provide critically ill patients with high-quality care and an atmosphere in which to recuperate. However, all too often, the intensive environment, which is often busy, chaotic, and noisy, may contribute to just the opposite. Patients overstimulated with noise, lights, and other distractions often suffer from sleep deprivation. Research in medicine and nursing has shown that sleep deprivation can have detrimental effects on an ailing patient. Therefore, a quiet time program was developed in the neuro-ICU to reduce noise and light levels, with the ultimate goal to allow sleep. Quiet time, a period of reduced controllable noise and light, took place twice daily coinciding with circadian rhythms. The study included 50 neuro-ICU patients, 35 observed during day hours and 15 observed during night hours. Noise and light levels were measured at multiple locations before, during, and after quiet time hours. Patients' sleep behavior was recorded every half hour, beginning 1/2 hour before quiet time until 30 minutes after. Analysis of data, adjusted for multiple testing and repeated measures on patients, demonstrated significantly lower noise and light levels during day shift quiet time. In addition, patients were significantly more likely to be observed sleeping during day shift quiet time hours.