Impact of sleep disturbances on outcomes in intensive care units

• Published in: Critical care (London, England) England), 2024-10, Vol.28 (1), p.331, Article 331
• Main Authors: Marchasson, Laura, Rault, Christophe, Le Pape, Sylvain, Arrivé, François, Coudroy, Rémi, Frat, Jean-Pierre, Bironneau, Vanessa, Jutant, Etienne-Marie, Heraud, Quentin, Drouot, Xavier, Thille, Arnaud W
• Format: Article
• Language: English
• Subjects: Aged; Care and treatment; Critical Illness - therapy; Critically ill; Female; Health aspects; Humans; Intensive care units; Intensive Care Units - organization & administration; Intensive Care Units - statistics & numerical data; Male; Middle Aged; Patient outcomes; Polysomnography - methods; Respiration, Artificial - adverse effects; Respiration, Artificial - methods; Respiration, Artificial - statistics & numerical data; Respiratory Insufficiency - physiopathology; Respiratory Insufficiency - therapy; Sleep deprivation; Sleep Wake Disorders - epidemiology; Sleep Wake Disorders - etiology; Sleep Wake Disorders - physiopathology; Sleep Wake Disorders - therapy
• ISSN: 1364-8535; 1466-609X; 1466-609X; 1364-8535
• DOI: 10.1186/s13054-024-05118-4

Sleep deprivation is common in intensive care units (ICUs) and may alter respiratory performance. Few studies have assessed the role of sleep disturbances on outcomes in critically ill patients. We hypothesized that sleep disturbances may be associated with poor outcomes in ICUs. Post-hoc analysis pooling three observational studies assessing sleep by complete polysomnography in 131 conscious and non-sedated patients included at different times of their ICU stay. Sleep was assessed early in a group of patients admitted for acute respiratory failure while breathing spontaneously (n = 34), or under mechanical ventilation in patients with weaning difficulties (n = 45), or immediately after extubation (n = 52). Patients admitted for acute respiratory failure who required intubation, those under mechanical ventilation who had prolonged weaning, and those who required reintubation after extubation were considered as having poor clinical outcomes. Durations of deep sleep, rapid eye movement (REM) sleep, and atypical sleep were compared according to the timing of polysomnography and the clinical outcomes. Whereas deep sleep remained preserved in patients admitted for acute respiratory failure, it was markedly reduced under mechanical ventilation and after extubation (p