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Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study

INTRODUCTION: Many intensive care patients experience sleep disruption potentially related to noise, light and treatment interventions. The purpose of this study was to characterise, in terms of quantity and quality, the sleep of intensive care patients, taking into account the impact of environment...

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Autores principales: Elliott, Rosalind, McKinley, Sharon, Cistulli, Peter, Fien, Mary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733429/
https://www.ncbi.nlm.nih.gov/pubmed/23506782
http://dx.doi.org/10.1186/cc12565
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author Elliott, Rosalind
McKinley, Sharon
Cistulli, Peter
Fien, Mary
author_facet Elliott, Rosalind
McKinley, Sharon
Cistulli, Peter
Fien, Mary
author_sort Elliott, Rosalind
collection PubMed
description INTRODUCTION: Many intensive care patients experience sleep disruption potentially related to noise, light and treatment interventions. The purpose of this study was to characterise, in terms of quantity and quality, the sleep of intensive care patients, taking into account the impact of environmental factors. METHODS: This observational study was conducted in the adult ICU of a tertiary referral hospital in Australia, enrolling 57 patients. Polysomnography (PSG) was performed over a 24-hour period to assess the quantity (total sleep time: hh:mm) and quality (percentage per stage, duration of sleep episode) of patients' sleep while in ICU. Rechtschaffen and Kales criteria were used to categorise sleep. Interrater checks were performed. Sound pressure and illuminance levels and care events were simultaneously recorded. Patients reported on their sleep quality in ICU using the Richards Campbell Sleep Questionnaire and the Sleep in Intensive Care Questionnaire. Data were summarised using frequencies and proportions or measures of central tendency and dispersion as appropriate and Cohen's Kappa statistic was used for interrater reliability of the sleep data analysis. RESULTS: Patients' median total sleep time was 05:00 (IQR: 02:52 to 07:14). The majority of sleep was stage 1 and 2 (medians: 19 and 73%) with scant slow wave and REM sleep. The median duration of sleep without waking was 00:03. Sound levels were high (mean Leq 53.95 dB(A) during the day and 50.20 dB(A) at night) and illuminance levels were appropriate at night (median <2 lux) but low during the day (median: 74.20 lux). There was a median 1.7 care events/h. Patients' mean self-reported sleep quality was poor. Interrater reliability of sleep staging was highest for slow wave sleep and lowest for stage 1 sleep. CONCLUSIONS: The quantity and quality of sleep in intensive care patients are poor and may be related to noise, critical illness itself and treatment events that disturb sleep. The study highlights the challenge of quantifying sleep in the critical care setting and the need for alternative methods of measuring sleep. The results suggest that a sound reduction program is required and other interventions to improve clinical practices to promote sleep in intensive care patients. TRIAL REGISTRATION: Australian New Zealand clinical trial registry (http://www.anzctr.org.au/): ACTRN12610000688088.
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spelling pubmed-37334292013-08-05 Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study Elliott, Rosalind McKinley, Sharon Cistulli, Peter Fien, Mary Crit Care Research INTRODUCTION: Many intensive care patients experience sleep disruption potentially related to noise, light and treatment interventions. The purpose of this study was to characterise, in terms of quantity and quality, the sleep of intensive care patients, taking into account the impact of environmental factors. METHODS: This observational study was conducted in the adult ICU of a tertiary referral hospital in Australia, enrolling 57 patients. Polysomnography (PSG) was performed over a 24-hour period to assess the quantity (total sleep time: hh:mm) and quality (percentage per stage, duration of sleep episode) of patients' sleep while in ICU. Rechtschaffen and Kales criteria were used to categorise sleep. Interrater checks were performed. Sound pressure and illuminance levels and care events were simultaneously recorded. Patients reported on their sleep quality in ICU using the Richards Campbell Sleep Questionnaire and the Sleep in Intensive Care Questionnaire. Data were summarised using frequencies and proportions or measures of central tendency and dispersion as appropriate and Cohen's Kappa statistic was used for interrater reliability of the sleep data analysis. RESULTS: Patients' median total sleep time was 05:00 (IQR: 02:52 to 07:14). The majority of sleep was stage 1 and 2 (medians: 19 and 73%) with scant slow wave and REM sleep. The median duration of sleep without waking was 00:03. Sound levels were high (mean Leq 53.95 dB(A) during the day and 50.20 dB(A) at night) and illuminance levels were appropriate at night (median <2 lux) but low during the day (median: 74.20 lux). There was a median 1.7 care events/h. Patients' mean self-reported sleep quality was poor. Interrater reliability of sleep staging was highest for slow wave sleep and lowest for stage 1 sleep. CONCLUSIONS: The quantity and quality of sleep in intensive care patients are poor and may be related to noise, critical illness itself and treatment events that disturb sleep. The study highlights the challenge of quantifying sleep in the critical care setting and the need for alternative methods of measuring sleep. The results suggest that a sound reduction program is required and other interventions to improve clinical practices to promote sleep in intensive care patients. TRIAL REGISTRATION: Australian New Zealand clinical trial registry (http://www.anzctr.org.au/): ACTRN12610000688088. BioMed Central 2013 2013-03-18 /pmc/articles/PMC3733429/ /pubmed/23506782 http://dx.doi.org/10.1186/cc12565 Text en Copyright © 2013 Elliott et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Elliott, Rosalind
McKinley, Sharon
Cistulli, Peter
Fien, Mary
Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study
title Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study
title_full Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study
title_fullStr Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study
title_full_unstemmed Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study
title_short Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study
title_sort characterisation of sleep in intensive care using 24-hour polysomnography: an observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733429/
https://www.ncbi.nlm.nih.gov/pubmed/23506782
http://dx.doi.org/10.1186/cc12565
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