Sleep and critical care

Bijwadia, Jagdeep; Ejaz, Muhammad S

doi:10.1097/mcc.0b013e3283220dc7

Cited by 26 publications

(15 citation statements)

References 31 publications

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“…The hospital environment (eg, noise, light, activities) in of itself may explain in part the poor sleep efficiency we observed for both TBI and OSCI patients. Severe sleep abnormalities have been reported in critically ill non-TBI patients in the ICU, [27][28][29] with up to 96% of actual sleep time spent in the lighter stages of sleep. Moreover, the previous actigraphy study conducted by our group showed an absence of well-consolidated rest periods among TBI patients hospitalized in the ICU.…”

Section: Sleep Deprivation Hypothesismentioning

confidence: 99%

Sleep in the Acute Phase of Severe Traumatic Brain Injury

Wiseman-Hakes

Duclos

Blais

et al. 2016

Neurorehabil Neural Repair

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Background and Objectives The onset of pervasive sleep-wake disturbances associated with traumatic brain injury (TBI) is poorly understood. This study aimed to (a) determine the feasibility of using polysomnography in patients in the acute, hospitalized stage of severe TBI and (b) explore sleep quality and sleep architecture during this stage of recovery, compared to patients with other traumatic injuries. Methods A cross-sectional case-control design was used. We examined the sleep of 7 patients with severe TBI (17-47 years; 20.3 ± 15.0 days postinjury) and 6 patients with orthopedic and/or spinal cord injuries (OSCI; 19-58 years; 16.9 ± 4.9 days postinjury). One night of ambulatory polysomnography was performed at bedside. Results Compared to OSCI patients, TBI patients showed a significantly longer duration of nocturnal sleep and earlier nighttime sleep onset. Sleep efficiency was low and comparable in both groups. All sleep stages were observed in both groups with normal proportions according to age. Conclusion Patients in the acute stage of severe TBI exhibit increased sleep duration and earlier sleep onset, suggesting that the injured brain enhances sleep need and/or decreases the ability to maintain wakefulness. As poor sleep efficiency could compromise brain recovery, further studies should investigate whether strategies known to optimize sleep in healthy individuals are efficacious in acute TBI. While there are several inherent challenges, polysomnography is a useful means of examining sleep in the early stage of recovery in patients with severe TBI.

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Section: Sleep Deprivation Hypothesismentioning

confidence: 99%

Sleep in the Acute Phase of Severe Traumatic Brain Injury

Wiseman-Hakes

Duclos

Blais

et al. 2016

Neurorehabil Neural Repair

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“…Sleep disruption is a common problem amongst patients in intensive care units (ICU) (Bijwadia & Ejaz ). Frequent disturbed sleep can lead to detriments to patients' health and recovery (Friese , Gardner et al .…”

Section: Introductionmentioning

confidence: 99%

“…Sleep disruption is a common problem amongst patients in intensive care units (ICU) (Bijwadia & Ejaz 2009). Frequent disturbed sleep can lead to detriments to patients' health and recovery (Friese 2008, Gardner et al 2009, Kamdar et al 2012) and previous studies have associated disturbed sleep presence with delirium in ICU patients (Figueroa-Ramos et al 2009, Trompeo et al 2011.…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of the effects of listening to non‐commercial music on quality of nocturnal sleep and relaxation indices in patients in medical intensive care unit

Lai

Chang

et al. 2012

Journal of Advanced Nursing

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“…TCT is associated with prolonged hospitalization, lasting from 30 days to several months, with patients and families experiencing a series of physical, social, and psychological stressors that lead to sleep disruption [16,17]. In adult patients the effects of prolonged sleep disruption during hospitalization have shown to persist for months after discharge, affecting sleep quality and quality of life [18][19][20]. Hospitalized patients along with their caregivers experience repeated interruptions and intermittent loud noises that compromise sleep quality [1,21], such as frequent room entries, overnight administration of medication, monitor Biology of Blood and Marrow Transplantation journal homepage: www.bbmt.org alarms, hospital staff, and cleaning services [8,18].…”

Section: Introductionmentioning

confidence: 99%

Quality Improvement Initiative to Reduce Nighttime Noise in a Transplantation and Cellular Therapy Unit

Badia

Hickey

Flesch

et al. 2019

Biology of Blood and Marrow Transplantation

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Sleep is an essential biologic function vital for physiologic rest, healing, and emotional well-being. Sleep disruption is commonly seen in patients and caregivers with lengthy hospital stays such as patients undergoing hematopoietic stem cell transplantation and cellular therapy (TCT). Sleep disruption can lead to increased stress and fatigue, affecting caregivers' ability to support their loved one. The global aim of our quality improvement initiative was to improve sleep quality in TCT patients and caregivers. The smart aim of our project was to decrease nighttime hallway noise from 47 dB to 43 dB and decrease the number of overnight noise peaks greater than 60 dB from 865 to 432 in 6 months. Through a cross-sectional quantitative and qualitative evaluation of sleep we had previously identified poor sleep quality, and with a cross-sectional focus group analysis of patients, caregivers, and medical staff we identified the factors associated with poor sleep. Hallway noise was a major factor. A simplified failure mode analysis identified 4 main key drivers; unobtrusive nighttime cleaning process, nighttime awareness maintenance system, quiet nighttime nursing system, and reliable nighttime awareness system. Several plan-do-study-act interventions took place and were adopted. From January to June 2018 the overnight mean decibel level decreased from 47 dB to 44 dB (6% reduction). Overnight noise spikes above 60 dB decreased from a mean of 865 spikes to a mean of 463 spikes (46% reduction). With a quality improvement initiative, we identified the causes of hallway nighttime hospital unit noise that negatively impact sleep and through a teambased approach performed interventions that successfully mitigated these factors.

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Sleep and critical care

Abstract: This article discusses the available data on sleep disruption in patients in the ICU and implications with discussion of effects of ventilators and commonly used medications in the ICU. We will conclude with interventions to improve sleep in the intensive care setting.

Cited by 26 publications

References 31 publications

Sleep in the Acute Phase of Severe Traumatic Brain Injury

Sleep in the Acute Phase of Severe Traumatic Brain Injury

A randomized controlled trial of the effects of listening to non‐commercial music on quality of nocturnal sleep and relaxation indices in patients in medical intensive care unit

Quality Improvement Initiative to Reduce Nighttime Noise in a Transplantation and Cellular Therapy Unit

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