Coulrophobia—a fear of clowns—may be familiar to many adults, but when it comes to visiting children in the hospital, these funny folk can have quite a positive effect. Recent research published in Scientific Reports found that by reducing stress and anxiety, improving cooperation, and bettering a kid’s hospital experience, medical clowns can improve sleep and shorten the length of time spent in the hospital. While previous research has found that medical clowns have improved children’s hospital stays and medical treatment success, their effect on sleep has not been well-studied.

A previous study found poor sleep quality among hospitalized children. They had later bedtimes and wake-up times, woke more often during the night, and spent less time sleeping overall. The hospital environment poses significant challenges to a regular sleep pattern. Noisy, bright-lit wards, being woken up for patient care, and a shift in the light-dark cycle, can all make sleeping difficult. The fact that a youngster is sleeping in an unfamiliar environment and may have anxiety or pain can make matters even worse. A lack of sleep may delay healing and recovery and make pain seem worse. 

The most recent study involved pediatric patients ages 2-17 who stayed in the hospital for at least two nights—though kids with a known fear of clowns were excluded. On one night of their stay, half of the patients got a private visit before bedtime from a medical clown who would spend between 15 and 30 minutes using music, guided meditation, and other clowning techniques to promote relaxation. The other half of the patients did not receive a clown visit.

The kids who engaged with the clowns slept an average of 54 minutes longer—almost an hour more—on the night they received the clown visit compared to the night they did not. On the night of the visit, they also had fewer nighttime awakenings, and better sleep efficiency, or the ratio of time spent in bed trying to sleep and the total amount of time spent asleep. These children also slept an average of 70 minutes longer than the children who did not visit with a clown.

Unexpectedly, researchers found a significant difference in how long the patient spent in the hospital. Children who visited with the clowns stayed an average of 23 hours, nearly a full day, less than those who did not. 

A visit from a medical clown before bedtime “has shown to be even more effective than other behavioral interventions tested in previous studies, including parent-recorded bedtime stories and multicomponent relaxation intervention,” the study authors wrote. “Therefore, the findings of the study are innovative and further emphasize the positive impact of medical clowns on patients and the paramount importance of their integration into the medical system.”

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3 Sources

  1. Shimshi-Barash, M., Orlin, I., Jacob, T., Kushnir, G., Rawashdeh, L., Rothem Nachmias, E., Meiri, N., & Pillar, G. (2024). Medical clowns improve sleep and shorten hospitalization duration in hospitalized children. Scientific Reports, 14(1), 2357.
  2. Meltzer, L. J., Davis, K. F., & Mindell, J. A. (2012). Patient and parent sleep in a children’s hospital. Pediatric Nursing, 38(2), 64–71; quiz 72.
  3. Hu, R.-F., Jiang, X.-Y., Chen, J., Zeng, Z., Chen, X. Y., Li, Y., Huining, X., Evans, D. J., & Wang, S. (2015). Non-pharmacological interventions for sleep promotion in the intensive care unit. Cochrane Database of Systematic Reviews, 10.

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