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Clinical Investigations in Critical CareSleep in Critically Ill Patients Requiring Mechanical Ventilation
Section snippets
Patient Recruitment
The study protocol and consent were approved by the Wellesley Central Hospital Research Ethics Committee. Written informed consent was obtained from the patient or, if the patient had evidence of an altered sensorium (inappropriate or absent response to commands), from a family member. Patients admitted to the Ewart Angus ICU between April 21, 1997, and June 30, 1998, were screened for eligibility. Selection criteria were endotracheal intubation and anticipated further mechanical ventilation of
Characteristics of Study Population on Day of ICU Admission
Twenty-six patients were studied from April 1997 to May 1998. We were unable to score six records, owing to technical problems. EEG recordings could not be interpreted because of electrical artifact in four of six and because of severe respiratory artifact in two of six patients. Both patients with severe respiratory artifact were very edematous. Characteristics of the study population on the day of ICU admission are given in Table 1. The majority of our patients were admitted to the ICU for
Discussion
This study is our first investigation of sleep in critically ill patients who are mechanically ventilated. None of the patients we studied demonstrated normal sleep. Furthermore, using standard electrophysiologic criteria,32 sleep as it is usually defined was not present in all critically ill patients. Based on our observations, we propose criteria to select critically ill patients at risk of disrupted sleep; APS < 13, GCS ≥ 10, and sedative medication doses (in the preceding 24 h): lorazepam
ACKNOWLEDGMENT
The authors thank the nursing, respiratory therapy, physical therapy, and support staff of the Ewart Angus ICU, Wellesley Central Hospital, for their special care of the patients involved in this study. Dejan Lukic, Mary Luccisano, and Nicky Grenier of the Wellesley Central Hospital sleep laboratory provided outstanding technical support.
References (40)
- et al.
Late postoperative nocturnal episodic hypoxaemia and associated sleep pattern
Br J Anaesth
(1994) - et al.
Sleep in herniorrhaphy patients
Am J Surg
(1979) - et al.
Sleep patterns in the intensive care unit and on the ward after acute myocardial infarction
Electrocephalogr Clin Neurophysiol
(1978) - et al.
Sleep disturbances after open heart surgery
Am J Cardiol
(1977) - et al.
Adverse environmental conditions in the respiratory and medical ICU settings
Chest
(1994) - et al.
Effects of sleep deprivation and reversal of diurnal activity on protein metabolism of young men
Am J Clin Nutr
(1966) - et al.
Periodic limb movements during sleep in patients with congestive heart failure
Chest
(1996) - et al.
Determinants of daytime sleepiness in obstructive sleep apnea
Chest
(1988) Infrequent periodic sleep disruption: effects on sleep, performance and mood
Physiol Behav
(1989)- et al.
The 1994 Clinical Research Award: a prospective clinical study of the polysomnographic stages of sleep after burn injury
J Burn Care Rehab
(1994)
Measurement of nocturnal sleep patterns in trauma patients
Heart Lung
A description of night sleep patterns in the critical care unit
Heart Lung
Anesthesia with abdominal surgery leads to intense REM sleep during the first postoperative week
Anesthesiology
Quantity and quality of patients' sleep and sleep-disturbing factors in a respiratory intensive care unit
J Adv Nurs
Patterns of sleep in postcardiotomy patients
Nurs Res
Sleep in the surgical intensive care unit: continuous polygraphic recording of sleep in nine patients receiving postoperative care
Br Med J
Sleep and delirium after open heart surgery
Br J Surg
Effects of critical care unit noise on the subjective quality of sleep
J Adv Nurs
The correlation between sleep deprivation and the intensive care unit syndrome
Heart Lung
Sleep disorders in psychiatric illness
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Funded, in part, by grants from the Ontario Thoracic Society.