Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects

被引:353
作者
Gabor, JY
Cooper, AB
Crombach, SA
Lee, B
Kadikar, N
Bettger, HE
Hanly, PJ
机构
[1] St Michaels Hosp, Dept Med, Toronto, ON M5B 1W8, Canada
[2] Univ Toronto, Sunnybrook & Womens Coll Hlth Sci Ctr, Dept Crit Care Med, Toronto, ON, Canada
关键词
sleep disruption; intensive care unit noise; polysomnography;
D O I
10.1164/rccm.2201090
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Recent studies have challenged the traditional hypothesis that excessive environmental noise is central to the etiology of sleep disruption in the intensive care unit (ICU). We characterized potentially disruptive ICU noise stimuli and patient-care activities and determined their relative contributions to sleep disruption. Furthermore, we studied the effect of noise in isolation by placing healthy subjects in the ICU in both normal and noise-reduced locations. Seven mechanically ventilated patients and six healthy subjects were studied by continuous 24-hour polysomnography with time-synchronized environmental monitoring. Sound elevations occurred 36.5 +/- 20.1 times per hour of sleep and were responsible for 20.9 +/- 11.3% of total arousals and awakenings. Patient-care activities occurred 7.8 +/- 4.2 times per hour of sleep and were responsible for 7.1 +/- 4.4% of total arousals and awakenings. Healthy subjects slept relatively well in the typically loud ICU environment and experienced a quantitative, but not qualitative, improvement in sleep in a noise-reduced, single-patient ICU room. Our data indicate that noise and patient-care activities account for less than 30% of arousals and awakenings and suggest that other elements of the critically ill patient's environment or treatment should be investigated in the pathogenesis of ICU sleep disruption.
引用
收藏
页码:708 / 715
页数:8
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