Annually 250,000 critically ill children are admitted to 350 pediatric intensive care units (ICUs) in the United States. Most (>97%) survive, however many critical illness survivors suffer significant long-term health impairments that result in lower quality of life (HRQL) and increased health care use. Acute sleep deficiency is common following critical illness. However, limited knowledge exists of the potential impact of deficient sleep on markers of health following critical illness such as physical and mental health, HRQL, or health services utilization. Thus, the primary objective of this proposal is to systematically document for the first time the impact of sleep deficiency on health, quality of life, and health care utilization in children surviving critical illness. The central hypothesis is that sleep deficiency persist and negatively impact health following critical illness. Candidate. Dr. Cornelius Groenewald is an Assistant Professor in the Department of Anesthesiology and Pain Medicine at the University of Washington and Seattle Children?s Hospital. With the support of an interdisciplinary team of mentors, this award provides him an unparalleled opportunity to develop a unique skill set in sleep research in children with critical illness. Through the training plan the candidate will obtain specialized training in 1) sleep medicine and physiology, 2) actigraphy monitoring to assess sleep in children, 3) digital health interventions with children 4) qualitative and mixed-methods research, 5) research design and statistical methods for longitudinal research and clinical trials, and 6) experiential learning in grant writing. Research. The research plan involves 2 studies: 1) a prospective cohort study using objective and subjective measures of sleep over 12 months in children with critical illness and controls (80=critically ill and 40=age and sex matched controls)(study 1), and 2) a qualitative study to understand child and parent perspectives on managing sleep deficiency following critical illness (study 2). Primary aims are to 1) characterize the nature, trajectories, and impact of sleep deficiency experienced by children following critical illness (study 1), 2) identify risk factors associated with persistent sleep deficiency over 12 months in children following critical illness (study 1), and 3) identify, directly from children and their parents, perspectives on the barriers and facilitators of implementing interventions to manage sleep deficiency following critical illness (study 2). The combination of strong mentorship team, specialized career development training, and proposed research projects will allow Dr. Groenewald to gain the expertise needed to develop two streams of research: 1) an R01 multisite, observational study aimed at determining mechanisms underlying sleep disturbances following critical illness, and 2) a R21 pilot trial to test a technology-delivered sleep self-management intervention in children surviving critical illness.

Public Health Relevance

Children surviving critical illness have profound long term health and quality of life impairments. The goal of this research program is to characterize the role of persistent sleep deficiency on long term health outcomes following critical illness in children. This information will be used to develop intervention strategies to improve outcomes following critical illness.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Mentored Patient-Oriented Research Career Development Award (K23)
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NHLBI Mentored Patient-Oriented Research Review Committee (MPOR)
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Brown, Marishka
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Seattle Children's Hospital
United States
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Groenewald, Cornelius B; Rabbitts, Jennifer A; Hansen, Elizabeth E et al. (2018) Racial differences in opioid prescribing for children in the United States. Pain 159:2050-2057