The following is a summary of “Impact of sleep disturbances on outcomes in intensive care units,” published in the October 2024 issue of Critical Care by Marchasson et al. 

Sleep disturbances are common in patients admitted to ICU and may affect respiratory function, but their impact on outcomes remains unclear.  

Researchers conducted a retrospective study to analyze an association between the patients admitted to ICU and sleep disturbances with poor outcomes.   

They analyzed 3 studies to assess sleep in 131 conscious, non-sedated individuals at different times during their ICU stay. Sleep was evaluated early in people admitted with acute respiratory failure while breathing spontaneously (n = 34), those receiving mechanical ventilation due to weaning difficulties (n = 45), and those immediately after extubation (n = 52). People with acute respiratory failure who required intubation, with prolonged weaning under mechanical ventilation, and with the need for reintubation after extubation were categorized as having poor clinical outcomes. The duration of deep sleep, rapid eye movement (REM) sleep, and atypical sleep were compared on the timing of polysomnography and clinical outcomes.  

The results showed that deep sleep was preserved in individuals with acute respiratory failure but significantly reduced in those under mechanical ventilation and after extubation (P < 0.01). Atypical sleep occurred more frequently in individuals on mechanical ventilation compared to those breathing spontaneously (P < 0.01); REM sleep was rare throughout their ICU stay. Individuals who experienced a complete absence of REM sleep (50%) had a higher chance of poor outcomes than those with persistent REM sleep (24% vs 9%, P = 0.03).  

They concluded the complete absence of REM sleep was significantly linked to critically ill individuals with poor clinical outcomes.   

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05118-4