Sleep disturbances in critically ill patients in ICU: how much do we know?

Abstract

Sleep disturbances in the intensive care unit (ICU) seem to lead to development of delirium, prolonged ICU stay, and increased mortality. That is why sufficient sleep is important for good outcome and recovery in critically ill patients. A variety of small studies reveal pathological sleep patterns in critically ill patients including abnormal circadian rhythm, high arousal and awakening index, reduced Slow Wave Sleep, and Rapid Eye Movement sleep. The purpose of this study is to summarise different aspects of sleep-awake disturbances, causes and handling methods in critically ill patients by reviewing the underlying literature. There are no studies of level 1 evidence proving the positive impact of the tested interventions on the critically ill patients' sleep pattern. Thus, disturbed sleep in critically ill patients with all the severe consequences remains an unresolved problem and needs further investigation.

The Psychometric Properties of Richard Campbell Sleep Questionnaire in Patients in Intensive Care Unit

“…In earlier studies regarding the sleep of ICU patients, predominantly objective methods have been used and only in some extent various subjective ones (11). The commonest objective method is polysomnography, which is the most reliable and valid method available to measure sleep; it is also against it that other methods are evaluated (11,12).…”

“…The commonest objective method is polysomnography, which is the most reliable and valid method available to measure sleep; it is also against it that other methods are evaluated (11,12). The disadvantage of polysomnography, as with several other objective methods, is that it requires advanced equipment and is time and cost consuming, due to the fact that it requires expertise to interpret the results.…”

“…In subjective methodologies, the patients themselves describe the quality and quantity of their own sleep, usually with the aid of a questionnaire. The advantage of these methods is that it takes relatively little time to collect information on patients' sleep and process the data (11,12). The Richard Campbell sleep questionnaire (RCSQ) is one of the instruments that, due to its unique features, such as simplicity, Copyright © 2018, Journal of Critical Care Nursing.…”

Sleep Monitoring Techniques within Intensive Care

“…Polysomnography (PSG) studies reporting the sleep architecture of ICU patients reveal that whilst the total sleep time acquired is relatively normal (6-8 hours) [19][20][21]; it is often non-consolidated and highly fragmented [22][23]. Research indicates that ICU patients sleep traverses both day and night contributing to circadian disturbances [24][25].…”

Sleep Disturbances and Critical Illness

“…Poor sleep quality is associated with apprehension and distress, which affect patients' quality of life. Altered sleep architecture, quantity and quality increase the risk for delirium and other complications, ICU length of stay and mortality [2]. Sleep disturbances can also significantly affect patients' recovery from critical illness [3].…”