Sleep in the intensive care unit

Abstract

Poor sleep quality is a consistently reported by patients in the ICU. In such a potentially hostile environment, sleep is extremely fragmented and sleep architecture is unconventional, with a predominance of superficial sleep stages and a limited amount of time spent in the restorative stages. Among the causes of sleep disruption in the ICU are factors intrinsic to the patients and the acute nature of their condition, as well as factors related to the ICU environment and the treatments administered, such as mechanical ventilation and drug therapy. Although the consequences of poor sleep quality for the recovery of ICU patients remain unknown, it seems to influence the immune, metabolic, cardiovascular, respiratory, and neurological systems. There is evidence that multifaceted interventions focused on minimizing nocturnal sleep disruptions improve sleep quality in ICU patients. In this article, we review the literature regarding normal sleep and sleep in the ICU. We also analyze sleep assessment methods; the causes of poor sleep quality and its potential implications for the recovery process of critically ill patients; and strategies for sleep promotion.

Factors determining sleep in patients hospitalised in ICUs in a hospital in Northern Poland

“…In addition, 40% of them remembered awakenings from the previous night and 30% had problems with falling asleep [30]. Aspects of mechanical ventilation most affecting sleep continuity include increased respiratory effort, abnormal gas exchange, and the absence of synchronous ventilation [1]. For this reason, patients undergoing ventilator therapy experience less effective, interrupted sleep in contrast to patients who breathe on their own.…”

“…The second questionnaire used was a modified Freedman scale developed by Shailesh Bihari (Fig. 1) [1]. The questionnaire required retrospection, and the subjects were asked to evaluate their general sleep quality on a 10-point scale, where 1 stood for the worst possible quality and 10 for the best possible quality.…”

“…In its complexity, the Intensive Care Unit (ICU) environment is largely based on the continuous observation and monitoring of the patient. As a result, the physical and technical aspects of care are given priority, while the mental sphere and the patient's needs are largely omitted [1]. These needs include sleep, which, in the light of advanced medical procedures performed in an ICU, may seem to be less significant.…”

Sleep Quality of Patients Admitted to the Coronary Care Unit: Pilot Study

“…Also, the results of a study showed that the prevalence of sleep disorders in coronary patients admitted to Intensive Care Units was high (81 %) (Sepahvand 2014). Poor sleep quality among patients in care units is associated with frequent abnormalities, changes in circadian rhythm, and reduction in depth and restoration phase of sleep (Beltrami et al, 2015). Patients admitted to the Intensive Care Unit suffered from a severe sleep disorder, an abnormal increase in 1 and 2 sleep stages, reduced night time sleeping, and lack of deep sleep (Hardin 2009).…”

Consolidating in the present, with an eye to the future

“…There has also been a significant increase in the number of JBP articles related to invasive procedures, 7 , 8 as well as to the field of thoracic surgery, 9 clearly indicating an expansion of the representativeness of the Journal. In parallel, JBP review articles have sought to illuminate subjects of more general interest to our readership, such as sleep, 10 idiopathic pulmonary fibrosis, 11 and imaging, 12 together with special sections on continuing education in scientific methodology and imaging, with the goal of making the JBP an accessible tool for keeping everyone with an interest in respiratory medicine up to date.…”