Abstract
Background and objectiveThe sleep architecture of critically ill patients being treated in Intensive Care Units (ICU) and High Dependency Units (HDU) is frequently unsettled and inadequate both qualitatively and quantitatively. The study aimed to investigate and elucidate factors influencing sleep architecture and quality in ICU and HDU in a limited resource setting with financial constraints, lacking human resources and technology for routine monitoring of noise, light and sleep promotion strategies in ICU.MethodsThe study was longitudinal, prospective, hospital-based, analytic, and observational. Insomnia Severity Index (ISI) and the Epworth Sleepiness Scale (ESS) pre hospitalisation scores were recorded. Patients underwent 24-hour polysomnography (PSG) with the simultaneous monitoring of noise and light in their environments. Patients stabilised in ICU were transferred to HDU, where the 24-hour PSG with the simultaneous monitoring of noise and light in their environments was repeated. Following PSG, the Richards-Campbell Sleep Questionnaire (RCSQ) was employed to rate patients’ sleep in both the ICU and HDU.ResultsOf 46 screened patients, 26 patients were treated in the ICU and then transferred to the HDU. The mean (SD) of the study population’s mean (SD) age was 35.96 (11.6) years with a predominantly male population (53.2% (n=14)). The mean (SD) of the ISI and ESS scores were 6.88 (2.58) and 4.92 (1.99), respectively. The comparative analysis of PSG data recording from the ICU and HDU showed a statistically significant reduction in N1, N2 and an increase in N3 stages of sleep (p<0.05). Mean (SD) of RCSQ in the ICU and the HDU were 54.65 (7.70) and 60.19 (10.85) (p-value = 0.04) respectively. The disease severity (APACHE II) has a weak correlation with the arousal index but failed to reach statistical significance (coeff= 0.347, p= 0.083).ConclusionSleep in ICU is disturbed and persisting during the recovery period in critically ill. However, during recovery, sleep architecture shows signs of restoration.
Highlights
Sleep disturbance is defined as the perceived or actual alterations in nighttime sleep with the subsequent daytime impairment of quality of life
One patient was planned for extubation during the PSG study
The study was conducted in a limited resource setting lacking human resources constraints and technology for routine monitoring of noise, light and sleep promotion strategies in the Intensive Care Units (ICU)
Summary
Sleep disturbance is defined as the perceived or actual alterations in nighttime sleep (both quantity and quality) with the subsequent daytime impairment of quality of life. The median duration of sleep without awakening is has been reported to be three minutes [2], with almost 50% of the patient’s total sleep time occurring during daylight hours [3]. The sleep architecture of critically ill patients being treated in Intensive Care Units (ICU) and High Dependency Units (HDU) is frequently unsettled and inadequate both qualitatively and quantitatively. Patients underwent 24-hour polysomnography (PSG) with the simultaneous monitoring of noise and light in their environments. Patients stabilised in ICU were transferred to HDU, where the 24-hour PSG with the simultaneous monitoring of noise and light in their environments was repeated. The comparative analysis of PSG data recording from the ICU and HDU showed a statistically significant reduction in N1, N2 and an increase in N3 stages of sleep (p
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
