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Wednesday, September 05, 2012

Improving Sleep in Intensive Care Units

Intensive care units (ICUs) are not fun places to be. By definition, people placed on such a unit need intense medical care for a serious medical condition (which is often life-threatening). While on the ICU, the body needs to rest in order to heal and the best way to do that is through the restorative powers of sleep.

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With worse sleep in the ICU, it will take longer to leave the ICU, the patient may develop delirium, and worst of all, the chances of dying increases. Delirium is a state of fluctuating mental confusion that develops over a few hours or days. Some studies have shown that people in ICUs have sleep problems characterized by frequent awakening, abnormal biological clock rhythms, and/or a decreased length of time in the 3rd and 4th stages of sleep.

To address this problem, treatment of sleep disorders in critically care patients are needed. However, in a newly published review article in the medical journal, Acta Anaesthesiologica Scandinavica, researchers found that there was not good scientific evidence that existing treatments of sleep disorders in the ICU setting worked. The authors suggested large multi-center studies to address this problem with larger groups of patients that were more alike as a group.

The authors also suggested some specific possible changes such as: 1) improving the ICU setting, 2) not using as many medications known to cause sleep problems, 3) use of melatonin pills (a chemical that is used naturally in the body to promote sleep), and 4) using more types of mechanical ventilation to improve synchrony between the patient and the ventilator.

Related blog entry: Treating Sleep Problems in Multiple Sclerosis: An Update

Reference:  Boyko, Y., Ording, H., Jennum, P. (2012). Sleep disturbances in critically ill patients in ICU: how much do we know? Anaesthesiologica Scandinavica, 56, 950-958. 

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