The quality and quantity of sleep on dexmedetomidine during high-flow nasal cannula oxygen therapy in critically ill patients

Abstract

Purpose : High-flow nasal cannula oxygen therapy (HFNC) is a new type of non-invasive respiratory support for acute respiratory failure patients. However, patients receiving HFNC often develop sleep disturbances. We therefore examined whether dexmedetomidine could preserve the sleep characteristics in patients who underwent HFNC. Patients and Methods : This was a pilot, randomized controlled study. We assigned critically ill patients treated with HFNC to receive dexmedetomidine (0.2 to 0.7 µg / kg / h, DEX group) or not (non-DEX group) at night (9:00 p.m. to 6:00 a.m.). Polysomnograms were monitored during the study period. The primary outcomes were total sleep time (TST), sleep efficiency and duration of stage 2 non-rapid eye movement (stage N2) sleep. Results : Of the 28 patients who underwent randomization, 24 were included in the final analysis (12 patients per group). Dexmedetomidine increased the TST (369 min vs. 119 min, p = 0.024) and sleep efficiency (68% vs. 22%, P = 0.024). The duration of stage N2 was increased in the DEX group compared with the non-DEX group, but this finding did not reach statistical significance. The incidences of respiratory depression and hemodynamic instability were similar between the two groups. Conclusions : In critically ill patients who underwent HFNC, dexmedetomidine may optimize the sleep quantity without any adverse events.

Effects of dexmedetomidine on postoperative sleep quality: a systematic review and meta-analysis of randomized controlled trials

“…This result suggests that although the TST may be normal or even increased, critically ill patients are considered to have qualitatively disrupted sleep. Recent studies have reported positive effects of DEX on sleep quality in critically ill patients with or without surgical procedures [12,46]. Future studies should focus on the duration or frequency of DEX administration to improve the sleep quality in these patients.…”

Dexmedetomidine nasal administration improves perioperative sleep quality and neurocognitive deficits in elderly patients undergoing general anesthesia

“…As the brain tissues of elderly patients show different degrees of degeneration, the oxygenation of the organism also has a significant decrease, and they are more prone to sleep problems after surgery, which can have a greater impact on the postoperative recovery of patients [ 12 ]. Dexmedetomidine is an a2 agonist in clinical practice, and when it enters the patient’s organism, it has an inhibitory effect on the patient’s central nervous system conduction, and, at the same time, it also has an effect on the nerve reflexes and reduces the patient’s pain level [ 13 ]. Therefore, in this study, 120 patients admitted to our hospital for various elective laparoscopic gynecological surgeries lasting more than 1 h under general anesthesia from July 2021 to March 2023 were selected, and all subjects were divided into 3 groups according to the randomized numerical table method, and their relevant studies were conducted, and the results of the study are reported below.…”