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J Burn Care Res. 2015 Mar-Apr;36(2):266-71. doi: 10.1097/BCR.0000000000000066.

The effect of diphenhydramine on sleep in pediatric burn patients: a secondary analysis.

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  • 1From the Departments of *Nursing, †Nutrition, and ‡Surgery, Shriners Hospitals for Children, Cincinnati, Ohio; §Department of Advanced Nursing, Northern Kentucky University, Newport; ‖Institute for Biomedical Ethics, University of Basel, Switzerland; and ¶Department of Surgery, University of Cincinnati College of Medicine, Ohio.


Adequate sleep is essential for maintaining homeostasis, especially when recovering from an illness; however, studies have shown that sleep disruption and sleep deprivation are common in intensive care unit patients, including children who have sustained burn injury. The purpose of this study was to evaluate the effect of diphenhydramine (DPH) on sleep in pediatric intensive care unit burn patients using Myra Levine's Conservation Model as the organizing framework. For this study, secondary analysis of polysomnography data and retrospective chart review were used. Twelve DPH patients were pair matched in terms of morphine, midazolam, and methadone with 12 non-DPH patients. The data were analyzed using paired t-tests for each dependent variable and χ analysis was used for frequency determinations. There was no difference in demographics between the two groups. DPH patients took 4.3 ± 1.6 minutes to fall asleep whereas non-DPH patients took 15.8 ± 1.6 minutes to achieve sleep onset (P = .06). Patients receiving DPH achieved 297.6 ± 29.9 minutes of total sleep time whereas those not receiving DPH achieved only 209.2 ± 29.9 minutes (P < .05). There was minimal difference in the mean percentage of sleep time in stages 3 and 4 between the two groups. The DPH group did have 50% more rapid eye movement sleep time compared with the non-DPH group. Even though DPH did not result in a statistical improvement in sleep quality, sleep quantity was increased in this study. More research is needed to find an effective sleep intervention in pediatric burn patients.

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