Reducing Night-Time Distress in Paediatric Complex Care

For children with complex health needs, a good night’s sleep is rarely straightforward. Overnight repositioning to prevent pressure ulcers is an essential clinical practice, but in paediatric home settings, it can be physically demanding, disruptive, and distressing for both the child and their caregivers.

A recent case study from Occupational Therapists at Somerset Council highlights how the Toto® Cradle has helped transform night-time care for two young patients, improving comfort, reducing pain, and supporting safer manual handling.

Supporting Comfort in Complex Home Environments

Jamie*, aged 10, has complex care needs and receives 24-hour support at home. He is at high-risk of developing pressure damage and sleeps in a bedroom with very limited space. His bed cannot be repositioned due to environmental constraints, and he is connected to multiple medical devices throughout the night. 

Manual repositioning presented several challenges:

• Increased risk of disturbing medical equipment

• Significant physical strain for carers

• Night-time disruption affecting sleep quality

• Difficulty maintaining consistent repositioning schedules

The clinical team required a solution that would work within the practical realities of Jamie’s home. Drawing on prior experience with the Toto Cradle in adult services, the Children’s Occupational Therapy team introduced the system into paediatric practice.

The Toto Cradle’s gentle, controlled automated lateral repositioning enabled Jamie to be turned safely without repeated manual handling. Crucially, the movement did not disturb his medical devices.

Since implementation:

• Jamie has experienced no pressure ulcers

• Manual handling demands have reduced significantly

• Night-time care has become less intrusive

• A sustainable long-term pressure area care solution is now in place

Jessica, Children’s Occupational Therapy Team Lead, described the outcome as providing “far improved” results, with safer movement and reduced caregiver burden in a highly complex home setting.

Reducing Pain and Improving Sleep

The team also trialled the Toto Cradle with Tommy*, aged 7, who experiences severe hip pain. Routine manual repositioning during the night was causing considerable distress and sleep disruption. A 7-day trial allowed his Occupational Therapists and caregiver to evaluate the system in real-world practice.

The results were significant:

• Automated lateral turning replaced repeated manual repositioning

• Noticeable reduction in distress during repositioning

• Improved sleep quality

• Safer, reduced manual handling for caregivers

By providing consistent pressure redistribution without repeated physical intervention, the Toto Cradle supported both clinical objectives and overall well-being.

Following these outcomes, the team shared the learning within CPD sessions to increase awareness of the system’s value in paediatric complex care pathways.

A Practical Solution for Paediatric Services

For children receiving complex care at home, night-time repositioning is about more than pressure ulcer prevention; it directly impacts comfort, pain management, sleep, and quality of life.

This case study demonstrates how automated lateral turning can:

• Maintain effective pressure redistribution

• Reduce night-time distress

• Minimise manual handling risk

• Support caregivers with safer working practices

For community teams, commissioners, and paediatric services seeking clinically effective, patient-centred solutions, Toto Cradle offers an effective and evidence-based approach to improving night-time care.

To learn more about how the Toto Cradle could support patient care, contact us today.

*Names have been changed to protect patient identity.