Sleep in the intensive care unit

Sairam Parthasarathy, Martin J. Tobin

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Abnormalities of sleep are extremely common in critically ill patients, but the mechanisms are poorly understood. About half of total sleep time occurs during the daytime, and circadian rhythm is markedly diminished or lost. Judgments based on inspection consistently overestimate sleep time and do not detect sleep disruption. Accordingly, reliable poly-graphic recordings are needed to measure sleep quantity and quality in critically ill patients. Critically ill patients exhibit more frequent arousals and awakenings than is normal, and decreases in rapid eye movement and slow wave sleep. The degree of sleep fragmentation is at least equivalent to that seen in patients with obstructive sleep apnea. About 20% of arousals and awakenings are related to noise, 10% are related to patient care activities, and the cause for the remainder is not known; severity of underlying disease is likely an important factor. Mechanical ventilation can cause sleep disruption, but the precise mechanism has not been defined. Sleep disruption can induce sympathetic activation and elevation of blood pressure, which may contribute to patient morbidity. In healthy subjects, sleep deprivation can decrease immune function and promote negative nitrogen balance. Measures to improve the quantity and quality of sleep in critically ill patients include careful attention to mode of mechanical ventilation, decreasing noise, and sedative agents (although the latter are double-edged swords).

Original languageEnglish (US)
Title of host publicationApplied Physiology in Intensive Care Medicine
PublisherSpringer Berlin Heidelberg
Pages147-156
Number of pages10
ISBN (Print)3540373616, 9783540373612
DOIs
StatePublished - 2006
Externally publishedYes

Fingerprint

Intensive Care Units
Sleep
Critical Illness
Sleep Deprivation
Arousal
Artificial Respiration
Noise
REM Sleep
Obstructive Sleep Apnea
Circadian Rhythm
Hypnotics and Sedatives
Patient Care
Healthy Volunteers
Nitrogen
Blood Pressure
Morbidity

Keywords

  • Arousal
  • Artificial respiration
  • Critical illness
  • Mechanical ventilation
  • Sleep

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Parthasarathy, S., & Tobin, M. J. (2006). Sleep in the intensive care unit. In Applied Physiology in Intensive Care Medicine (pp. 147-156). Springer Berlin Heidelberg. https://doi.org/10.1007/3-540-37363-2_28

Sleep in the intensive care unit. / Parthasarathy, Sairam; Tobin, Martin J.

Applied Physiology in Intensive Care Medicine. Springer Berlin Heidelberg, 2006. p. 147-156.

Research output: Chapter in Book/Report/Conference proceedingChapter

Parthasarathy, S & Tobin, MJ 2006, Sleep in the intensive care unit. in Applied Physiology in Intensive Care Medicine. Springer Berlin Heidelberg, pp. 147-156. https://doi.org/10.1007/3-540-37363-2_28
Parthasarathy S, Tobin MJ. Sleep in the intensive care unit. In Applied Physiology in Intensive Care Medicine. Springer Berlin Heidelberg. 2006. p. 147-156 https://doi.org/10.1007/3-540-37363-2_28
Parthasarathy, Sairam ; Tobin, Martin J. / Sleep in the intensive care unit. Applied Physiology in Intensive Care Medicine. Springer Berlin Heidelberg, 2006. pp. 147-156
@inbook{da1af9e7c10744a79e0fe966b1661bb6,
title = "Sleep in the intensive care unit",
abstract = "Abnormalities of sleep are extremely common in critically ill patients, but the mechanisms are poorly understood. About half of total sleep time occurs during the daytime, and circadian rhythm is markedly diminished or lost. Judgments based on inspection consistently overestimate sleep time and do not detect sleep disruption. Accordingly, reliable poly-graphic recordings are needed to measure sleep quantity and quality in critically ill patients. Critically ill patients exhibit more frequent arousals and awakenings than is normal, and decreases in rapid eye movement and slow wave sleep. The degree of sleep fragmentation is at least equivalent to that seen in patients with obstructive sleep apnea. About 20{\%} of arousals and awakenings are related to noise, 10{\%} are related to patient care activities, and the cause for the remainder is not known; severity of underlying disease is likely an important factor. Mechanical ventilation can cause sleep disruption, but the precise mechanism has not been defined. Sleep disruption can induce sympathetic activation and elevation of blood pressure, which may contribute to patient morbidity. In healthy subjects, sleep deprivation can decrease immune function and promote negative nitrogen balance. Measures to improve the quantity and quality of sleep in critically ill patients include careful attention to mode of mechanical ventilation, decreasing noise, and sedative agents (although the latter are double-edged swords).",
keywords = "Arousal, Artificial respiration, Critical illness, Mechanical ventilation, Sleep",
author = "Sairam Parthasarathy and Tobin, {Martin J.}",
year = "2006",
doi = "10.1007/3-540-37363-2_28",
language = "English (US)",
isbn = "3540373616",
pages = "147--156",
booktitle = "Applied Physiology in Intensive Care Medicine",
publisher = "Springer Berlin Heidelberg",

}

TY - CHAP

T1 - Sleep in the intensive care unit

AU - Parthasarathy, Sairam

AU - Tobin, Martin J.

PY - 2006

Y1 - 2006

N2 - Abnormalities of sleep are extremely common in critically ill patients, but the mechanisms are poorly understood. About half of total sleep time occurs during the daytime, and circadian rhythm is markedly diminished or lost. Judgments based on inspection consistently overestimate sleep time and do not detect sleep disruption. Accordingly, reliable poly-graphic recordings are needed to measure sleep quantity and quality in critically ill patients. Critically ill patients exhibit more frequent arousals and awakenings than is normal, and decreases in rapid eye movement and slow wave sleep. The degree of sleep fragmentation is at least equivalent to that seen in patients with obstructive sleep apnea. About 20% of arousals and awakenings are related to noise, 10% are related to patient care activities, and the cause for the remainder is not known; severity of underlying disease is likely an important factor. Mechanical ventilation can cause sleep disruption, but the precise mechanism has not been defined. Sleep disruption can induce sympathetic activation and elevation of blood pressure, which may contribute to patient morbidity. In healthy subjects, sleep deprivation can decrease immune function and promote negative nitrogen balance. Measures to improve the quantity and quality of sleep in critically ill patients include careful attention to mode of mechanical ventilation, decreasing noise, and sedative agents (although the latter are double-edged swords).

AB - Abnormalities of sleep are extremely common in critically ill patients, but the mechanisms are poorly understood. About half of total sleep time occurs during the daytime, and circadian rhythm is markedly diminished or lost. Judgments based on inspection consistently overestimate sleep time and do not detect sleep disruption. Accordingly, reliable poly-graphic recordings are needed to measure sleep quantity and quality in critically ill patients. Critically ill patients exhibit more frequent arousals and awakenings than is normal, and decreases in rapid eye movement and slow wave sleep. The degree of sleep fragmentation is at least equivalent to that seen in patients with obstructive sleep apnea. About 20% of arousals and awakenings are related to noise, 10% are related to patient care activities, and the cause for the remainder is not known; severity of underlying disease is likely an important factor. Mechanical ventilation can cause sleep disruption, but the precise mechanism has not been defined. Sleep disruption can induce sympathetic activation and elevation of blood pressure, which may contribute to patient morbidity. In healthy subjects, sleep deprivation can decrease immune function and promote negative nitrogen balance. Measures to improve the quantity and quality of sleep in critically ill patients include careful attention to mode of mechanical ventilation, decreasing noise, and sedative agents (although the latter are double-edged swords).

KW - Arousal

KW - Artificial respiration

KW - Critical illness

KW - Mechanical ventilation

KW - Sleep

UR - http://www.scopus.com/inward/record.url?scp=84889982558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889982558&partnerID=8YFLogxK

U2 - 10.1007/3-540-37363-2_28

DO - 10.1007/3-540-37363-2_28

M3 - Chapter

AN - SCOPUS:84889982558

SN - 3540373616

SN - 9783540373612

SP - 147

EP - 156

BT - Applied Physiology in Intensive Care Medicine

PB - Springer Berlin Heidelberg

ER -