Are Sleep Alterations the Cause of ICU Delirium?/Reply

[...]the proportion of patients with delirium at the time of polysomnography was 32% for patients with normal sleep and 40% for those with atypical sleep (P = 0.76), and only two patients with atypical sleep or no REM sleep developed late delirium. [...]it seems difficult to claim that sleep alterat...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2018-09, Vol.198 (5), p.692-694
Main Authors: Thille, Arnaud W, Reynaud, Faustine, Marie, Damien, Barrau, Stéphanie, Rousseau, Ludivine, Rault, Christophe, Drouot, Xavier, Skrobik, Yoanna, Devlin, John W
Format: Article
Language:English
Subjects:
Anesthesia
Clinical trials
Copyright
Delirium
Intensive care
Mortality
Patients
Prevention
Quality
Questionnaires
Sleep deprivation
Ventilators
Weaning
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Summary:[...]the proportion of patients with delirium at the time of polysomnography was 32% for patients with normal sleep and 40% for those with atypical sleep (P = 0.76), and only two patients with atypical sleep or no REM sleep developed late delirium. [...]it seems difficult to claim that sleep alterations can be a major factor promoting delirium. [...]the real impact of dexmedetomidine on sleep in critically ill patients seems rather weak. [...]current measuring standards for delirium are not perfect, in that delirium screening substitutes for a diagnosis in most published studies despite the fact that original screening-tool validation papers excluded important ICU subpopulations (4). [...]best practice" assessments do not consider qualitative or patient-experience-driven data to inform us as to what constitutes "optimal sleep quality" for the patient (4).
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201804-0609LE