Matthews Ellyn E
College of Nursing, University of Colorado Denver, 13120 E 19th Ave, Aurora, CO 80045, USA.
AACN Adv Crit Care. 2011 Jul-Sep;22(3):204-24. doi: 10.1097/NCI.0b013e31822052cb.
Sleep disturbances and fatigue are significant problems for critically ill patients. Existing sleep disorders, underlying medical/surgical conditions, environmental factors, stress, medications, and other treatments all contribute to a patient's inability to sleep. Sleep disturbance and debilitating fatigue that originate during acute illness may continue months after discharge from intensive care units (ICUs). If these issues are unrecognized, lack of treatment may contribute to chronic sleep problems, impaired quality of life, and incomplete rehabilitation. A multidisciplinary approach that incorporates assessment of sleep disturbances and fatigue, environmental controls, appropriate pharmacologic management, and educational and behavioral interventions is necessary to reduce the impact of sleep disturbances and fatigue in ICU patients. Nurses are well positioned to identify issues in their own units that prevent effective patient sleep. This article will discuss the literature related to the occurrence, etiology, and risk factors of sleep disturbance and fatigue and describe assessment and management options in critically ill adults.
睡眠障碍和疲劳是重症患者面临的重大问题。现有的睡眠障碍、潜在的内科/外科疾病、环境因素、压力、药物及其他治疗方法都会导致患者无法入睡。急性疾病期间出现的睡眠障碍和使人虚弱的疲劳感可能在重症监护病房（ICU）出院数月后仍会持续。如果这些问题未被识别，缺乏治疗可能会导致慢性睡眠问题、生活质量受损以及康复不完全。采用多学科方法，包括评估睡眠障碍和疲劳、环境控制、适当的药物管理以及教育和行为干预，对于减轻睡眠障碍和疲劳对ICU患者的影响是必要的。护士能够很好地识别本病房中妨碍患者有效睡眠的问题。本文将讨论与睡眠障碍和疲劳的发生、病因及危险因素相关的文献，并描述重症成年患者的评估和管理方法。
