Bourne Richard S, Minelli Cosetta, Mills Gary H, Kandler Rosalind
Sheffield Teaching Hospitals, Critical Care Directorate, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK, S10 2JF.
Crit Care. 2007;11(4):226. doi: 10.1186/cc5966.
Sleep disturbances are common in critically ill patients and have been characterised by numerous studies using polysomnography. Issues regarding patient populations, monitoring duration and timing (nocturnal versus continuous), as well as practical problems encountered in critical care studies using polysomnography are considered with regard to future interventional studies on sleep. Polysomnography is the gold standard in objectively measuring the quality and quantity of sleep. However, it is difficult to undertake, particularly in patients recovering from critical illness in an acute-care area. Therefore, other objective (actigraphy and bispectral index) and subjective (nurse or patient assessment) methods have been used in other critical care studies. Each of these techniques has its own particular advantages and disadvantages. We use data from an interventional study to compare agreement between four of these alternative techniques in the measurement of nocturnal sleep quantity. Recommendations for further developments in sleep monitoring techniques for research and clinical application are made. Also, methodological problems in studies validating various sleep measurement techniques are explored.
Current Controlled Trials ISRCTN47578325.
睡眠障碍在重症患者中很常见,并且已经有大量使用多导睡眠图的研究对其进行了描述。关于患者群体、监测持续时间和时间安排(夜间监测与持续监测),以及在使用多导睡眠图的重症监护研究中遇到的实际问题,在未来关于睡眠的干预性研究中都需要加以考虑。多导睡眠图是客观测量睡眠质量和数量的金标准。然而,它实施起来很困难,尤其是在急性护理区域从重症疾病中恢复的患者身上。因此,在其他重症监护研究中使用了其他客观方法(活动记录仪和脑电双频指数)和主观方法(护士或患者评估)。这些技术中的每一种都有其自身的特定优缺点。我们使用一项干预性研究的数据来比较这四种替代技术在夜间睡眠量测量方面的一致性。针对睡眠监测技术在研究和临床应用方面的进一步发展提出了建议。此外,还探讨了验证各种睡眠测量技术的研究中的方法学问题。
当前对照试验ISRCTN47578325。