Predictors of Sleep Quality and Successful Weaning From Mechanical Ventilation Among Patients in Respiratory Care Centers

Abstract

A strong relationship was identified between disease severity and quality of sleep. Both factors are significant predictors of successful weaning from mechanical ventilation. A better understanding of the related risk factors will help improve the care provided by nurses and medical personnel to patients undergoing the weaning process.

Association of intensive care unit delirium with sleep disturbance and functional disability after critical illness: an observational cohort study

“…Notably, regression analysis also identified that older age was associated with improved sleep scores at follow-up. This finding differs from several studies in post-ICU patients which found that older age was associated with worse sleep, albeit using different sleep instruments in heterogeneous critically ill populations [ 38 – 40 ]. Furthermore, in non-critically ill populations, age is consistently associated with decreased total sleep time and sleep efficiency, less time spent in deep sleep stages, and worse self-reported sleep [ 41 ].…”

Sleep Disturbance after Hospitalization and Critical Illness: A Systematic Review

“…Several studies analyzed the effects of in-hospital factors, such as Acute Physiology and Chronic Health (APACHE) scores (a measure of disease severity), ventilator days, ICU and hospital length of stay, and ICU medication use. In these studies, sleep disturbance was associated with having poor sleep quality in the hospital ward (but not in the ICU for the same study), APACHE II scores, ICU acute stress symptoms, and total days of hospital opioid use (29,34,38,40). Three studies, however, found no association between various in-hospital factors and poor post-ICU sleep, including ICU and hospital length of stay, APACHE scores, admission diagnosis, or mechanical ventilation days (29,33,35).…”

“…Orwelius and colleagues (33) noted that self-reported concurrent disease before hospitalization (inquiring about numerous chronic conditions) was a significant driver of poor sleep (odds ratio of 2.51 for poor sleep quality at 6-mo follow-up; P , 0.001). Chen and colleagues (34) similarly found that increasing number of chronic diseases (at least three to four; P = 0.014) independently predicted poor sleep quality in respiratory care center patients being weaned from mechanical ventilation. In contrast, Solverson and colleagues (40) found no association between pre-existing comorbidity (cancer, asthma/chronic obstructive pulmonary disease, cardiovascular disease, obesity, and diabetes) and sleep quality 3 months after discharge.…”

“…Our initial search revealed 2,054 unique citations. Screening of these citations identified 17 studies that assessed sleep in critically ill patients after hospital discharge (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). An additional 5 studies were identified through searching reference lists, yielding a total of 22 articles reviewed (44)(45)(46)(47)(48).…”

“…Nonmodifiable risk factors associated with poor posthospital sleep included female sex and increased age (27,34,37,46). Race and ethnicity data were explicitly reported in only four studies with predominantly white samples-one study calculated no difference in insomnia rates between white and nonwhite groups (32,35,38,43).…”