Sleep in intensive care unit: The role of environment

Abstract Purpose 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 methods Randomized controlled trial, crossover design. The night intervention “quiet rout...

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Bibliographic Details
Published in:Journal of critical care 2017-02, Vol.37, p.99-105
Main Authors: Boyko, Yuliya, MD, Jennum, Poul, DMSci, Nikolic, Miki, PhD, MSc, Holst, René, PhD, Oerding, Helle, DMSci, MD, Toft, Palle, DMSci
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anesthesia
Classification
Clinical Alarms
Critical Care
Critical Illness
Critically ill patients
Cross-Over Studies
Delirium
Electroencephalography
Environment
Environmental factors
Eye movements
Female
Humans
Intensive care
Intensive Care Units
Intervention
Male
Middle Aged
Mortality
Narcotics
Noise
Noise - prevention & control
Nurses
Patients
Polysomnography
Respiration, Artificial
Sleep
Sleep scoring
Sound
Studies
Ventilation
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Summary:Abstract Purpose 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 methods Randomized 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. Results Sound 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. Conclusions Characteristics 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.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2016.09.005