Division of Pulmonary/Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
J Intensive Care Med. 2012 Mar-Apr;27(2):97-111. doi: 10.1177/0885066610394322. Epub 2011 Jan 10.
Critically ill patients frequently experience poor sleep, characterized by frequent disruptions, loss of circadian rhythms, and a paucity of time spent in restorative sleep stages. Factors that are associated with sleep disruption in the intensive care unit (ICU) include patient-ventilator dysynchrony, medications, patient care interactions, and environmental noise and light. As the field of critical care increasingly focuses on patients' physical and psychological outcomes following critical illness, understanding the potential contribution of ICU-related sleep disruption on patient recovery is an important area of investigation. This review article summarizes the literature regarding sleep architecture and measurement in the critically ill, causes of ICU sleep fragmentation, and potential implications of ICU-related sleep disruption on patients' recovery from critical illness. With this background information, strategies to optimize sleep in the ICU are also discussed.
危重症患者经常睡眠不佳,表现为频繁的睡眠中断、昼夜节律紊乱以及恢复性睡眠阶段时间不足。与 ICU 中睡眠中断相关的因素包括患者-呼吸机不同步、药物、患者护理交互以及环境噪音和光线。随着重症监护领域越来越关注重症患者在疾病后的身体和心理结果,了解 ICU 相关睡眠中断对患者康复的潜在贡献是一个重要的研究领域。本文综述了危重症患者睡眠结构和测量、ICU 睡眠碎片化的原因以及 ICU 相关睡眠中断对患者从重症中康复的潜在影响的相关文献。在此背景下,还讨论了优化 ICU 睡眠的策略。