Cargando…

Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels

BACKGROUND: It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain u...

Descripción completa

Detalles Bibliográficos
Autores principales: Elbaz, Maxime, Léger, Damien, Sauvet, Fabien, Champigneulle, Benoit, Rio, Stéphane, Strauss, Mélanie, Chennaoui, Mounir, Guilleminault, Christian, Mira, Jean Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Paris 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334329/
https://www.ncbi.nlm.nih.gov/pubmed/28255956
http://dx.doi.org/10.1186/s13613-017-0248-7
_version_ 1782511832670404608
author Elbaz, Maxime
Léger, Damien
Sauvet, Fabien
Champigneulle, Benoit
Rio, Stéphane
Strauss, Mélanie
Chennaoui, Mounir
Guilleminault, Christian
Mira, Jean Paul
author_facet Elbaz, Maxime
Léger, Damien
Sauvet, Fabien
Champigneulle, Benoit
Rio, Stéphane
Strauss, Mélanie
Chennaoui, Mounir
Guilleminault, Christian
Mira, Jean Paul
author_sort Elbaz, Maxime
collection PubMed
description BACKGROUND: It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain unclear. The aim of this study was therefore to evaluate carefully the impact of ICU sound intensity levels and their sources on ICU patients’ sleep over a 24-h period. METHODS: Sleep and sound levels were recorded in 11 ICU intubated patients who met the criteria. Sleep was recorded using a miniaturized multi-channel ambulatory recording device. Sound intensity levels and their sources were recorded with the Nox-T3 monitor. A 30-s epoch-by-epoch analysis of sleep stages and sound data was carried out. Multinomial and binomial logistic regressions were used to associate sleep stages, wakefulness and sleep–wake transitions with sound levels and their sources. RESULTS: The subjects slept a median of 502.2 [283.2–718.9] min per 24 h; 356.9 [188.6–590.9] min at night (22.00–08.00) and 168.5 [142.5–243.3] during daytime (8 am–10 pm). Median sound intensity level reached 70.2 [65.1–80.3] dBC at night. Sound thresholds leading to disturbed sleep were 63 dBC during the day and 59 dBC during the night. With levels above 77 dBC, the incidence of arousals (OR 3.9, 95% CI 3.0–5.0) and sleep-to-wake transitions (OR 7.6, 95% CI 4.1–14) increased. The most disturbing noises sources were monitor alarms (OR 4.5, 95% CI 3.5–5.6) and ventilator alarms (OR 4.2, 95% CI 2.9–6.1). CONCLUSIONS: We have shown, in a small group of 11 non-severe ICU patients, that sound level intensity, a major disturbance factor of sleep continuity, should be strictly controlled on a 24-h profile.
format Online
Article
Text
id pubmed-5334329
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Springer Paris
record_format MEDLINE/PubMed
spelling pubmed-53343292017-03-16 Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels Elbaz, Maxime Léger, Damien Sauvet, Fabien Champigneulle, Benoit Rio, Stéphane Strauss, Mélanie Chennaoui, Mounir Guilleminault, Christian Mira, Jean Paul Ann Intensive Care Research BACKGROUND: It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain unclear. The aim of this study was therefore to evaluate carefully the impact of ICU sound intensity levels and their sources on ICU patients’ sleep over a 24-h period. METHODS: Sleep and sound levels were recorded in 11 ICU intubated patients who met the criteria. Sleep was recorded using a miniaturized multi-channel ambulatory recording device. Sound intensity levels and their sources were recorded with the Nox-T3 monitor. A 30-s epoch-by-epoch analysis of sleep stages and sound data was carried out. Multinomial and binomial logistic regressions were used to associate sleep stages, wakefulness and sleep–wake transitions with sound levels and their sources. RESULTS: The subjects slept a median of 502.2 [283.2–718.9] min per 24 h; 356.9 [188.6–590.9] min at night (22.00–08.00) and 168.5 [142.5–243.3] during daytime (8 am–10 pm). Median sound intensity level reached 70.2 [65.1–80.3] dBC at night. Sound thresholds leading to disturbed sleep were 63 dBC during the day and 59 dBC during the night. With levels above 77 dBC, the incidence of arousals (OR 3.9, 95% CI 3.0–5.0) and sleep-to-wake transitions (OR 7.6, 95% CI 4.1–14) increased. The most disturbing noises sources were monitor alarms (OR 4.5, 95% CI 3.5–5.6) and ventilator alarms (OR 4.2, 95% CI 2.9–6.1). CONCLUSIONS: We have shown, in a small group of 11 non-severe ICU patients, that sound level intensity, a major disturbance factor of sleep continuity, should be strictly controlled on a 24-h profile. Springer Paris 2017-03-03 /pmc/articles/PMC5334329/ /pubmed/28255956 http://dx.doi.org/10.1186/s13613-017-0248-7 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Elbaz, Maxime
Léger, Damien
Sauvet, Fabien
Champigneulle, Benoit
Rio, Stéphane
Strauss, Mélanie
Chennaoui, Mounir
Guilleminault, Christian
Mira, Jean Paul
Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
title Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
title_full Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
title_fullStr Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
title_full_unstemmed Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
title_short Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
title_sort sound level intensity severely disrupts sleep in ventilated icu patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334329/
https://www.ncbi.nlm.nih.gov/pubmed/28255956
http://dx.doi.org/10.1186/s13613-017-0248-7
work_keys_str_mv AT elbazmaxime soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT legerdamien soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT sauvetfabien soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT champigneullebenoit soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT riostephane soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT straussmelanie soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT chennaouimounir soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT guilleminaultchristian soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels
AT mirajeanpaul soundlevelintensityseverelydisruptssleepinventilatedicupatientsthroughouta24hperiodapreliminary24hstudyofsleepstagesandassociatedsoundlevels