Activities such as bathing children are shifted to daylight hours. Also, playtime is promoted in the afternoon to help maintain a sense of normalcy and contrast nighttime rest. The hope is that children will sleep better and heal faster.

Physicians and hospital administrators are starting to recognize that “we’re doing some stuff in our hospitals that doesn’t really reflect what we’re telling people to do at home,” said Jennifer Jewell, a pediatric hospitalist at the Barbara Bush Children’s Hospital in Portland, Maine, who chairs the American Academy of Pediatrics’ Committee on Hospital Care.

Children’s hospitals aren’t yet held to the same patient satisfaction standards as other facilities. But there is growing interest in better catering to both children and their parents, doctors said. There’s the competitive element, noted Heather Walsh, a registered nurse who coordinates some of the quality improvement trainings undergone by clinical staff at Children’s National Health System in Washington, D.C. If families don’t like the care they get, they can go elsewhere.

And doctors are starting to realize that poor sleep isn’t just inconvenient. It can make children sicker.

In the intensive care unit, for instance, children who aren’t disturbed at night don’t need as much sedation or anesthesia, Kudchadkar said. That matters, she noted, since some of those drugs—benzodiazepines and prescription opioids—can be more dangerous for young patients to take. Kids who rest well at night are also more likely to get up and move around in the daytime.

In addition, because many children’s hospitals encourage parents to spend the night in their child’s room, late-night interruptions—whether a temperature check or the cleaning Zamboni in the hallway—wake them, too. As a result, parents aren’t rested when getting instructions for kids’ follow-up care. It’s easier to mishear or misremember a complicated medication instruction, said Lisa Meltzer, associate professor of pediatrics at National Jewish Health in Denver. Meltzer has also researched sleep quality in children’s hospitals.

“There’s more evidence really showing a direct link between insufficient and poor quality sleep and negative outcomes,” she said.

The changes can seem small. At Hopkins, blinds are typically lowered between 8 p.m. and 8 a.m., though nurses might adjust that based on a particular family’s needs and habits. Parents are asked their children’s favorite music to sleep to. The ICU’s child life staff will find those songs to play on portable radios. One teenager requested Tupac, while some patients might bring in the soundtracks from their favorite video games. In a number of rooms, many alerts no longer trigger loud beeps blasted from overhead speakers. Instead, they’re sent straight to the relevant nurse’s phone. He or she can see to the child’s need, but the noise doesn’t disturb the whole unit.