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- Title
Sleep on the ward in intensive care unit survivors: a case series of polysomnography.
- Authors
Wilcox, Mary Elizabeth; Rubenfeld, Gordon D.; Lim, Andrew S.; Black, Sandra E.; Pinto, Ruxandra; McAndrews, Mary Pat
- Abstract
Abstract: Background: Few studies have investigated sleep in patients after intensive care despite the possibility that inadequate sleep might further complicate an acute illness impeding recovery. Aims: To assess the quality and quantity of a patient's sleep on the ward by polysomnography (PSG) within a week of intensive care unit (ICU) discharge and to explore the prevalence of key in‐ICU risk factors for persistent sleep fragmentation. Methods: We enrolled 20 patients after they have been mechanically ventilated for at least 3 days and survived to ICU discharge. We included all patients over the age of 16 years and excluded patients with advanced cognitive impairment or who were unable to follow simple commands before their acute illness, primary admission diagnosis of neurological injury, uncontrolled psychiatric illness or not fluent in English. Results: Twenty patients underwent an overnight PSG recording on day 7 after ICU discharge (SD, 1 day). ICU survivors provided 292.8 h of PSG recording time with median recording times of 16.8 h (Interquartile range (IQR), 15.0–17.2 h). The median total sleep time per patient was 5.3 h (IQR, 2.6–6.3 h). In a multivariable regression model, postoperative admission diagnosis (P = 0.04) and patient report of poor ICU sleep (P = 0.001) were associated with less slow‐wave (restorative) sleep on the wards after ICU discharge. Conclusions: Patients reported poor sleep while in the ICU, and a postoperative admission diagnosis may identify a high‐risk subgroup of patients who may derive greater benefit from interventions to improve sleep hygiene.
- Subjects
PSYCHIATRIC diagnosis; DIAGNOSIS of neurological disorders; ARTIFICIAL respiration; COGNITION disorders; HOSPITAL care; INTENSIVE care units; LINGUISTICS; POSTOPERATIVE care; SLEEP; POLYSOMNOGRAPHY; SLEEP deprivation; MULTIPLE regression analysis; DISCHARGE planning; TREATMENT duration; DIAGNOSIS
- Publication
Internal Medicine Journal, 2018, Vol 48, Issue 7, p795
- ISSN
1444-0903
- Publication type
Article
- DOI
10.1111/imj.13791