Sleep and Mechanical Ventilation

Ozsancak, Aylin; D’Ambrosio, Carolyn; Garpestad, Erik; Schumaker, Greg; Hill, Nicholas S.

doi:10.1016/j.ccc.2008.03.002

Cited by 20 publications

(9 citation statements)

References 37 publications

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“…Preliminary 24-hour PSG in 4 patients receiving NPPV demonstrated frequent arousals and nearly absent REM and N3 sleep. 74 However, in patients with hypoventilation (eg obesity hypoventilation syndrome, neuromuscular disease, COPD), nocturnal NPPV may improve sleep quality while preventing worsening hypoventilation. 75 In summary, evaluation of ventilation mode and sleep quality is still an emerging field, and decisions should be individualized to optimize patient-ventilator mechanics.…”

Section: Mechanical Ventilationmentioning

confidence: 99%

Sleep Deprivation in Critical Illness

Kamdar

Needham

Collop

2011

J Intensive Care Med

363

182

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Critically ill patients frequently experience poor sleep, characterized by frequent disruptions, loss of circadian rhythms, and a paucity of time spent in restorative sleep stages. Factors that are associated with sleep disruption in the intensive care unit (ICU) include patient-ventilator dysynchrony, medications, patient care interactions, and environmental noise and light. As the field of critical care increasingly focuses on patients' physical and psychological outcomes following critical illness, understanding the potential contribution of ICU-related sleep disruption on patient recovery is an important area of investigation. This review article summarizes the literature regarding sleep architecture and measurement in the critically ill, causes of ICU sleep fragmentation, and potential implications of ICU-related sleep disruption on patients' recovery from critical illness. With this background information, strategies to optimize sleep in the ICU are also discussed.

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Section: Mechanical Ventilationmentioning

confidence: 99%

Sleep Deprivation in Critical Illness

Kamdar

Needham

Collop

2011

J Intensive Care Med

363

182

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“…Disruption of sleep is remarkably common in critically ill patients. [1][2][3] Abnormalities of sleep in this population include sleep deprivation, sleep fragmentation, and alterations in sleep architecture and circadian rhythm. These abnormalities may lead to undesirable consequences, such as delirium, delayed weaning in intensive care units (ICU), or late noninvasive ventilation (NIV) failures.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] Mechanical ventilation is one of the important factors associated with sleep disturbances in the ICU. 3,7,8 NIV has been increasingly used in ICU. [9][10][11] Although recognition of the importance of poor sleep in mechanical ventilation patients is increasing, only a few studies have investigated the effect of NIV on sleep in patients with acute respiratory failure (ARF).…”

Section: Introductionmentioning

confidence: 99%

Effects of Noninvasive Versus Invasive Mechanical Ventilation on Sleep in the Intensive Care Unit – A Pilot Study

et al. 2020

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Rationale: Use of noninvasive ventilation (NIV) has increased in intensive care units, but sleep during NIV has received little attention. The authors surmised that due to frequent air leaks and mask discomfort, patients receiving NIV would manifest poorer sleep quality than those receiving invasive mechanical ventilation (INV). Methods: A prospective observational study on patients receiving NIV or INV for respiratory failure in a medical intensive care unit or coronary care unit. Patients were monitored by polysomnography for 24 hours with simultaneous collection of data on ventilator and environmental parameters. Results: Eight subjects in each group were studied. Mean total sleep time was 7.29 +1.78 hours (range: 0.57–13.82) in the NIV versus 11.74 +0.65 hours (8.95–15.19) in the INV group (p=0.034). Sleep efficiency was lower in NIV than INV group (30.4% versus 53.3%, respectively; p=0.013). The NIV group had lighter sleep than the INV group (mean % of Stage 1: 36.9% versus 17.2% of total sleep time, respectively; p=0.000), whereas no significant differences were found for other stages. Median total arousal and awakening indexes were higher in the NIV group (16.8/hour versus 4.4/hour and 5.3/hour versus 2.1/hour, respectively; p=0.005), as well as spontaneous arousals and awakenings (p=0.006 and p=0.005, respectively). Sedation was provided mostly by intermittent bolus in the NIV group whereas often by infusion in the INV group. Conclusion: Compared to INV, NIV in critically ill patients was associated with poorer quality and quantity of sleep. Future studies should determine whether adjustments in ventilator settings, mask type or fit, or use of sedation/analgaesia can improve sleep in patients receiving NIV.

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“…In order to achieve and maintain a maximum level of sleep quality, it is necessary to implement organisational interventionssleep promoting strategies [24][25][26][27]. At present, some attention is directed to the effects and importance of mechanical ventilation on the quality of sleep [28,29]. A trial by Estebana et al [30] indicates that 40% of patients hospitalised at ICU require mechanical ventilation, although its exact effect on sleep architecture is uncertain.…”

Section: Introductionmentioning

confidence: 99%