Understanding patients’ nutritional status in relation to sleep deprivation

Abstract

In the April issue of Critical Care Nurse, Grimm discusses sleep deprivation in the OnlineNOW article “Sleep Deprivation in the Intensive Care Patient” (2020;40[2]:e16-e24). I have been a nurse for 12 years, with the majority of my background in intensive care. I recently transitioned into nursing administration as a nurse educator over medical/surgical units, clinics, day surgery, and intensive care. The topic of sleep deprivation concerns me because lack of sleep is associated with other problems such as longer stay, decreased healing, and decreased ability to absorb self-care education. All of these factors increase cost at the hospital’s expense. Recently, there has been a surge of patients with coronavirus disease 2019 in intensive care, and these patients are not sleeping well. Although the guidelines and research presented by Grimm offer excellent courses of action, I would like to emphasize another aspect that plays into sleep deprivation in intensive care: nutritional deficiency.Grimm addresses the shortage of studies for addressing sleep in the intensive care environment and their small sample sizes. The studies examied mortality, length of stay, and mechanical ventilation. The tools to assess sleep deprivation do not have credibility because of their lack of reliability and validity. Each patient’s body chemistry is different, and thus the pharmacological aspects in Grimm’s article need to be individualized for each patient. Further investigation into patients’ nutritional status would offer a distinctive insight because malnutrition has been shown to affect sleep. Ikonte et al1 mention a wide range of sleeping difficulties in relation to micronutrient intake. A lack of selenium may affect the ability to fall asleep, and the lack of potassium may cause more daytime sleepiness. Ikonte et al1 found that higher vitamin D intake was associated with better sleep, but the majority of people, even in sunshine states, have low vitamin D levels.A study that investigates how nutritional status affects sleeping patterns is warranted. Understanding patients’ nutritional status can provide a supplementary objective view of their condition in addition to feedback from patients themselves. Sleep deprivation is a concern for all intensive care patients, and understanding the role of nutrition in these patients could offer a solution to the root of the problem.