Circadian rhythms in pediatric neurocritical care: interfaces and opportunities
Abstract
Neurological disorders represent a disproportionate fraction of pediatric intensive care unit (PICU) admissions, accounting for approximately one quarter of all critically ill children. These conditions-including traumatic brain injury, hypoxic-ischemic encephalopathy, stroke, infectious and inflammatory disorders, epilepsy, and disorders of consciousness-are frequently accompanied by profound disruption of circadian rhythms. The circadian timekeeper is a fundamental biological system that coordinates physiology across scales, from molecular and cellular processes to systemic functions such as metabolism, immunity, thermoregulation, endocrine signaling, vascular regulation, synaptic physiology, and sleep-wake cycling. In the PICU and neonatal ICU (NICU) environments, multiple factors-including continuous or irregular lighting, noise, frequent clinical interventions, sedation, altered feeding schedules, and the pathophysiology of neurological injury itself-conspire to destabilize circadian organization. We summarize these contributing factors into pathways of critical care circadian desynchrony (C3D). This review examines the intersection between circadian biology and pediatric neurocritical care. We first summarize the molecular and systems-level architecture of the circadian system and distinguish circadian rhythms from sleep-wake state regulation. We then outline the development of sleep and circadian rhythms in the fetus, neonate, infant and child, emphasizing that…
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.