Nuttapol Rittayamai1,2,3, Elizabeth Wilcox1,4,5, Xavier Drouot6,7,8, Sangeeta Mehta1,4,9, Alberto Goffi1,4,5, Laurent Brochard10,11,12. 1. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. 2. Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada. 3. Division of Respiratory Diseases and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand. 4. Department of Medicine, University of Toronto, Toronto, Canada. 5. Division of Respirology (Critical Care), Department of Medicine, University Health Network, Toronto, Canada. 6. CHU de Poitiers, Service de Neurophysiologie Clinique, Poitiers, France. 7. Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France. 8. INSERM CIC 1402, Poitiers, France. 9. Department of Medicine, Mount Sinai Hospital, Toronto, Canada. 10. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. BrochardL@smh.ca. 11. Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada. BrochardL@smh.ca. 12. Department of Medicine, University of Toronto, Toronto, Canada. BrochardL@smh.ca.
Abstract
PURPOSE: Sleep is an essential physiologic process that helps to restore normal body homeostasis. Sleep disturbances have been shown to be associated with poor clinical outcomes, such as a greater risk of cardiovascular disease and increasing mortality. Critically ill patients, particularly those receiving mechanical ventilation, may be more susceptible to sleep disruption. METHODS AND RESULTS: Mechanical ventilation is an important factor influencing sleep in critically ill patients as it may have positive or negative effects, depending on patient population, mode, and specific settings. Other causes of sleep disruption include the acute illness itself, the daily routine care, and the effects of medications. Improving sleep in patients admitted to an intensive care unit has the potential to improve both short- and long-term clinical outcomes. In this article we review the specific aspects of sleep in critically ill mechanically ventilated patients, including abnormal sleep patterns and loss of circadian rhythm, as well as the effects of mechanical ventilation and intravenous sedatives on sleep quality and quantity. CONCLUSIONS: We provide recommendations for clinicians regarding optimal ventilatory settings and discuss fields for future research.
PURPOSE: Sleep is an essential physiologic process that helps to restore normal body homeostasis. Sleep disturbances have been shown to be associated with poor clinical outcomes, such as a greater risk of cardiovascular disease and increasing mortality. Critically illpatients, particularly those receiving mechanical ventilation, may be more susceptible to sleep disruption. METHODS AND RESULTS: Mechanical ventilation is an important factor influencing sleep in critically illpatients as it may have positive or negative effects, depending on patient population, mode, and specific settings. Other causes of sleep disruption include the acute illness itself, the daily routine care, and the effects of medications. Improving sleep in patients admitted to an intensive care unit has the potential to improve both short- and long-term clinical outcomes. In this article we review the specific aspects of sleep in critically ill mechanically ventilated patients, including abnormal sleep patterns and loss of circadian rhythm, as well as the effects of mechanical ventilation and intravenous sedatives on sleep quality and quantity. CONCLUSIONS: We provide recommendations for clinicians regarding optimal ventilatory settings and discuss fields for future research.
Entities:
Keywords:
Intensive care unit; Mechanical ventilation; Noninvasive ventilation; Sedatives; Sleep
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