1040 Post-ICU Daytime Sleep And Activity Impact Hospital Discharge Outcomes For Older ICU Survivors

Abstract

Abstract Introduction The aims of this study were to: describe post-ICU daytime sleep and activity among older ICU survivors within 24-48 hours post-ICU discharge, and to examine differences in post-ICU daytime sleep and activity by prospective acuity of discharge disposition at time of hospital discharge. Methods Within 24-48 hours of ICU discharge, we enrolled 30 ICU survivors who were at least 65 years old, functionally independent prior to hospitalization, and mechanically ventilated while in ICU. Actigraphy was used to estimate daytime total sleep time (TST, hours) and daytime activity (mean activity counts/minute) for one daytime period (06:00 AM to 22:00 PM) within 24-48 hours post-ICU discharge. Independent samples t-tests examined differences in mean daytime TST and daytime activity counts, between subjects who were discharged home versus those who were discharged to a facility (inpatient rehabilitation facility, skilled nursing facility, or long-term acute care hospital). Results The mean age was 71.37 ± 5.35 years; 63.3% were male and 76.7% were White non-Hispanic/Latino. The mean daytime TST was 7.61 ± 4.31 hours; the mean daytime activity count was 41.2 ± 28.24 counts/minute. Subjects who were discharged to a facility (8.88 ± 3.69 hours) slept significantly longer than those discharged to home (5.54 ± 4.21 hours; t(26) = 2.083, p = .047). Additionally, subjects who were discharged to a facility (32.96 ± 24.26 counts/minute) were significantly less active during the daytime than those discharged to home (54.42 ± 29.30 counts/minute; t(25) = -2.157, p = .041). Conclusion Older ICU survivors who were ultimately discharged to a facility slept significantly longer and were less active during the daytime hours immediately following transition out of ICU, compared to subjects who were discharged home. Intervention studies should investigate whether increasing daytime activity while promoting nighttime sleep consolidation following transfer out of ICU improves discharge outcomes. Support N/A