The Impact of Interventions to Improve Sleep on Delirium in the ICU: A Systematic Review and Research Framework*

Flannery, Alexander H.; Oyler, Douglas R.; Weinhouse, Gerald L.

doi:10.1097/ccm.0000000000001952

Cited by 71 publications

(44 citation statements)

References 51 publications

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“…Atypical sleep, characterised by the absence of stage 2 markers (absence of K complexes and sleep spindles), is a form of sleep frequently observed in ICU patients [20][21][22][23]. Loss of normal sleep may alter inspiratory muscle endurance in healthy subjects [24] and possibly lead to neurobehavioral disorders such as ICU delirium [25]. However, the influence of sleep on respiratory performance and weaning duration in patients under mechanical ventilation has never previously been studied.…”

Section: Introductionmentioning

confidence: 99%

Impact of sleep alterations on weaning duration in mechanically ventilated patients: a prospective study

et al. 2018

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Sleep is markedly altered in intensive care unit (ICU) patients and may alter respiratory performance. Our objective was to assess the impact of sleep alterations on weaning duration.We conducted a prospective physiological study at a French teaching hospital. ICU patients intubated for at least 24 h and difficult to wean were included. Complete polysomnography (PSG) was performed after the first spontaneous breathing trial failure. Presence of atypical sleep, duration of sleep stages, particularly rapid eye movement (REM) sleep, and electroencephalogram (EEG) reactivity at eyes opening were assessed by a neurologist.20 out of 45 patients studied (44%) had atypical sleep that could not be classified according to the standard criteria. Duration of weaning between PSG and extubation was significantly longer in patients with atypical sleep (median (interquartile range) 5 (2-8) 2 (1-2) days; p=0.001) and in those with no REM sleep compared with the others. Using multivariate logistic regression analysis, atypical sleep remained independently associated with prolonged weaning (>48 h after PSG). Altered EEG reactivity at eyes opening was a good predictor of atypical sleep.Our results suggest for the first time that brain dysfunction may have an influence on the ability to breathe spontaneously.

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Section: Introductionmentioning

confidence: 99%

Impact of sleep alterations on weaning duration in mechanically ventilated patients: a prospective study

et al. 2018

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“…C (n = 105; p < 0.05; three-way ANOVA model): Sex (F = 0; p = 0.929); age (F = 0.1; p = 0.736); admit (F = 1.8; p = 0.183) , 2016). There is also a growing number of studies demonstrating that the introduction of these organisational changes also reduces significantly the occurrence of delirium (Flannery et al, 2016;Patel et al, 2014). Usage of alternative and complementary techniques can improve the quality of sleep, too.…”

Section: Discussionmentioning

confidence: 99%

The reliability of the Czech version of the Richards-Campbell Sleep Questionnaire

Locihová¹,

Žiaková²,

Šerková³

et al. 2019

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Background: Sleep disorders are very frequent among all intensive care unit patients, and disturbed sleep quality has clear and straightforward negative consequences for patients' recovery and level of distress. To promote sleep, nurses must have instruments for observing and evaluating patients' sleep. Objective: The objective of the research was to determine the internal consistency of the Richards-Campbell Sleep Questionnaire (RCSQ) and to compare the selected relationships between the variables (gender, age, type of admission) in the Czech clinical environment of the intensive care unit. Design: Cross-sectional study. Methods: The RCSQ has been translated according to the translation and cultural adaptation manual. The quality of sleep was assessed using the Czech version of the RCSQ. The sample consisted of 105 patients hospitalised in an interdisciplinary intensive care unit. The quality of sleep was measured using a visual analogue scale (0-100). Results: The internal consistency (Cronbach's α) of the Czech version of the RCSQ is 0.89. The average RCSQ score in the sample was 53.2 (SD 20.1). Return to sleep was the lowest rated item at 51 (SD 24.2), while sleep quality was the highest rated item at 55.6 (SD 26.4). There was no statistically significant relationship (p < 0.05) between sleep quality and selected variables: age (F = 0.1; p = 0.736), gender (F = 0; p = 0.929), type of admission (F = 1.8; p = 0.183). Conclusions:The study demonstrates that the Czech version of the RCSQ is rated as a reliable tool and can be used to subjectively assess sleep quality in critically ill patients. The association between sleep quality and selected variables has not been statistically proven and its perception is very individual. Original research article Reliabilita české verze Richards-Campbell Sleep dotazníku SouhrnCíl: Cílem výzkumu bylo určit míru vnitřní konzistence Richards-Campbell Sleep Questionnaire (RCSQ) a porovnat vytipované vztahy mezi proměnnými (pohlaví, věk, druh přijetí) v českém klinickém prostředí jednotky intenzivní péče. Design: průřezová studie. Metodika: RCSQ byl přeložen podle manuálu pro překlad a kulturní adaptaci. Hodnocení kvality spánku bylo zjišťováno pomocí české verze RCSQ. Soubor tvořilo 105 pacientů hospitalizovaných na mezioborové jednotce intenzivní péče. Hodnocení kvality spánku bylo měřeno pomocí vizuální analogové škály (0-100). Výsledky: Průměrné skóre RCSQ v souboru bylo 53.2 (SD 20.1). Nejníže hodnocenou položkou bylo opětovné usínání po probuzení -51 (SD 24.2), naopak nejlépe hodnocenou položkou byla kvalita spánku -55.6 (SD 26.4). Vnitřní konzistence (Cronbachova α) české verze RCSQ je 0.89. Nebyl potvrzen statisticky signifikantní vztah (p < 0.05) mezi kvalitou spánku a vytipovanými proměnnými: věk (F = 0.1, p = 0.736), pohlaví (F = 0, p = 0.929), druh přijetí (F = 1.8, p = 0.183). Závěr: Studie demonstruje, že RCSQ v české verzi je hodnocen jako spolehlivý nástroj a může být používán k subjektivnímu hodnocení kvality spánku u kriticky nemocných. Asociace mezi kvalitou sp...

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“…A recent systemic review concluded that nonpharmacologic and pharmacologic sleep interventions may be a promising approach to improve delirium but that current research is limited by varied methodologies and significant bias, requiring a systematic approach in future research to evaluate the complex interactions between sleep interventions and delirium. 86 …”

Section: Delirium Preventionmentioning

confidence: 99%

Intensive Care Unit Delirium

2016

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The Impact of Interventions to Improve Sleep on Delirium in the ICU: A Systematic Review and Research Framework*

Cited by 71 publications

References 51 publications

Impact of sleep alterations on weaning duration in mechanically ventilated patients: a prospective study

Impact of sleep alterations on weaning duration in mechanically ventilated patients: a prospective study

The reliability of the Czech version of the Richards-Campbell Sleep Questionnaire

Intensive Care Unit Delirium

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