This paper examines the sleep disruption experienced by 36 families of technology-dependent children living at home in the United Kingdom. The paper begins with an overview of the qualitative study in which parents' experiences of sleep disruption emerged as a major theme. We then describe the nature of and reasons for the sleep disruption, the help families received with care overnight, and the effects of sleep disruption on parents in particular. This is followed by discussion of the implications of the findings for policy and practice as well as future research. Copyright # 2005 John Wiley & Sons, Ltd.
IntroductionAdvances in medical technologies have enabled more children with complex health care needs to survive and increasingly to be cared for at home with their families in the United Kingdom and other developed countries. In 2001, it was estimated that there were up to 6000 'technology-dependent' children living in the community in the United Kingdom (Glendinning and others, 2001). This term is used to describe children who use medical technologies that compensate for the partial failure or loss of a vital body function. Examples of such technologies include assisted ventilation, artificial nutrition, intravenous drug therapies, oxygen therapy and renal dialysis. These technologies involve the use of associated medical devices such as ventilators, feeding pumps and dialysis machines, as well as various instruments for monitoring the children's health status.Sleep problems are common among disabled children. Quine (2001) found that settling problems were reported for 41 per cent of children aged four to 12 in special schools compared with 27 per cent of children in mainstream schools; figures for night waking were 45 per cent compared with 13 per cent. Figures for children with severe learning disability are particularly high: for example, Bartlett and others (1985) reported problems in over 80 per cent of children aged up to Wiggs and Stores (1996) showed the average duration of current sleep problem was 7.13 years and others have found that they are not likely to disappear without intervention (Lancioni and others, 1999).
CHILDREN & SOCIETY VOLUME20 (2006) pp. 196-208 Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/CHI.881 Copyright Ó 2005 John Wiley & Sons, Ltd. 11 years and 77 per cent of 12 to 16 years. Such problems appear to be persistent: for example,Sleep problems encountered in studies of disabled children are broadly of two types: first, 'behavioural' problems relating to the initiation and maintenance of sleep and, second, 'physical' problems, such as upper airway obstruction and other physiological factors. However, these often co-exist. A third type of sleep problem has been suggested in studies of technology-dependent children: that of sleep disturbance due to the need for parents to administer treatment and/or manage the technology during the night and attend to false alarms on the devices going off and disturbing the child and parents (Kirk, 1998;Kirk a...