title: Infant sleep after immunization: randomized controlled trial of prophylactic acetaminophen.
abstract: OBJECTIVE
  To determine the effects of acetaminophen and axillary temperature responses on infant sleep duration after immunization.
  
  
  METHODS
  We conducted a prospective, randomized controlled trial to compare the sleep of 70 infants monitored by using ankle actigraphy for 24 hours before and after their first immunization series at ∼2 months of age. Mothers of infants in the control group received standard care instructions from their infants' health care provider, and mothers of infants in the intervention group were provided with predosed acetaminophen and instructed to administer a dose 30 minutes before the scheduled immunization and every 4 hours thereafter, for a total of 5 doses. Infant age and birth weight and immunization factors, such as acetaminophen use and timing of administration, were evaluated for changes in infant sleep times after immunization.
  
  
  RESULTS
  Sleep duration in the first 24 hours after immunization was increased, particularly for infants who received their immunizations after 1:30 pm and for those who experienced elevated temperatures in response to the vaccines. Infants who received acetaminophen at or after immunization had smaller increases in sleep duration than did infants who did not. However, acetaminophen use was not a significant predictor of sleep duration when other factors were controlled.
  
  
  CONCLUSIONS
  If further research confirms the relationship between time of day of vaccine administration, increased sleep duration after immunization, and antibody responses, then our findings suggest that afternoon immunizations should be recommended to facilitate increased sleep in the 24 hours after immunization, regardless of acetaminophen administration.
authors: Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, USA. linda.franck@nursing.ucsf.edu
authors: Linda
authors: L
authors: Franck
authors: Caryl L
authors: CL
authors: Gay
authors: Mary
authors: M
authors: Lynch
authors: Kathryn A
authors: KA
authors: Lee
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D058633:Antipyretics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007114:Immunization; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012890:Sleep / Q000187:drug effects*; D013997:Time Factors
chemical_list: D058633:Antipyretics; D000082:Acetaminophen