1 2 3 Corresponding author's email: geeta.mehta@utoronto.ca Rationale Patients in the intensive care unit (ICU) experience qualitative and quantitative sleep disruption. The consquences are sleep deprivation, and possibly adverse physiological and psychological sequelae. Patient-related factors (eg. illness, pain), environmental factors (eg. light, noise), and health support techniques (eg. mechanical ventilation, sedation) all contribute to sleep disruption. The current study reports patients' perspectives regarding sleep in the ICU. Methods Since June 2009, all patients admitted to the Mount Sinai Hospital Medical/Surgical ICU for ≥ 1 night were approached within 72 hours of discharge.Patients were asked to complete a sleep questionnaire if they passed an assessment of orientation and if they were able to communicate. The questionnaire explored the patients' quality and quantity of sleep in the ICU and following discharge from the ICU, ICU-related factors contributing to poor sleep, and possible changes in the ICU that could improve patients' sleep. Patient demographics (age, gender) as well as admission data (mechanical ventilation, sedation, APACHE II scores) were collected from patients' charts. ResultsThe target N is 100. In the first 48 patients (25 M:23 F), mean age ± SD was 56 ± 19 years (range 20-94), and mean APACHE II score was 18 ± 8. Of the sample, 33% were mechanically ventilated, and 62% received intravenous (IV) sedatives (intermittent or continuous). The average ICU length of stay was 4 nights. Sleep quality in the ICU was rated as poor or very poor by 69% of patients; and sleep quantity rated as poor or very poor by 58%. The 5 most frequently cited reasons for poor sleep were: noise (40%), pain (40%), presence of IV lines (35%), time disorientation (35%), and discomfort (30%). Patients most commonly identified the following as potentially improving sleep in the ICU: closing doors/blinds at night (42%), no unnecessary interruptions (40%), sleeping pills (33%), and dimmed lights (27%). Following ICU discharge, in-hospital sleep quality improved, primarily due to a reduction in pain (43%), fewer nocturnal interruptions (40%), and less noise (30%). Patients who received IV sedatives reported better quality of sleep (p<0.01). No significant correlations were found between perceived sleep quality and illness severity or intubation/mechanical ventilation. ConclusionsThe majority of ICU patients experience poor sleep in the ICU, regardless of whether they are intubated/mechanically ventilated. Patient-identified environmental factors to improve night-time sleep were considerable and modifiable, indicating the possibility for further development of clinical protocols. This abstract is funded by: Ontario Thoracic SocietyAm J Respir Crit Care Med
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