Sleep in intensive care unit: The role of environment

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• 作者：Yuliya Boyko ; MD^a ; ^{yuliya.boyko@rsyd.dk} ; Poul Jennum ; DMSci^b ; ^{poje@glo.regionh.dk} ; Miki Nikolic ; PhD ; MSc^c ; ^{miki.nikolic.01@regionh.dk} ; René ; Holst ; PhD^d ; ^{rholst@health.sdu.dk} ; Helle Oerding ; DMSci ; MD^e ; ^{oerding@dadlnet.dk} ; Palle Toft ; DMSci^f ; ^{palle.toft@rsyd.dk}
• 关键词：Sleep ; Critically ill patients ; Polysomnography ; Sleep scoring ; Environmental factors ; Noise
• 刊名：Journal of Critical Care
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：37
• 期：Complete
• 页码：99-105
• 全文大小：815 K
• 卷排序：37

文摘

To determine if improving intensive care unit (ICU) environment would enhance sleep quality, assessed by polysomnography (PSG), in critically ill mechanically ventilated patients.Materials and methodsRandomized controlled trial, crossover design. The night intervention “quiet routine” protocol was directed toward improving ICU environment between 10 pm and 6 am. Noise levels during control and intervention nights were recorded. Patients on mechanical ventilation and able to give consent were eligible for the study. We monitored sleep by PSG.The standard (American Association of Sleep Medicine) sleep scoring criteria were insufficient for the assessment of polysomnograms. Modified classification for sleep scoring in critically ill patients, suggested by Watson et al. (Crit Care Med 2013;41:1958-1967), was used.ResultsSound level analysis showed insignificant effect of the intervention on noise reduction (P = .3). The analysis of PSGs revealed that only 53% of the patients had identifiable characteristics of normal sleep, whereas 47% showed only pathologic patterns.ConclusionsCharacteristics of normal sleep were absent in many of the PSG recordings in these critically ill patients. We were not able to further reduce the already existing low noise levels in the ICU and did not find any association between the environmental intervention and the presence of normal sleep characteristics in the PSG.