Department of Intensive and Critical Care Medicine, Flinders Medical Centre, Bedford Park South Australia, Australia.
J Clin Sleep Med. 2012 Jun 15;8(3):301-7. doi: 10.5664/jcsm.1920.
Sleep disturbance is a frequently overlooked complication of intensive care unit (ICU) stay.
To evaluate sleep quality among patients admitted to ICU and investigate environmental and non-environmental factors that affect sleep quality in ICU.
Over a 22-month period, we consecutively recruited patients who spent ≥ 2 nights post-endotracheal extubation in ICU and who were orientated to time, place, and person on the day of discharge. Self-reported sleep quality, according to a modified Freedman questionnaire, which provided data on self-reported ICU sleep quality in ICU and environmental factors affecting sleep quality in the ICU, were collected. We also investigated non-environmental factors, such as severity of illness, ICU interventions, and medications that can affect sleep quality.
Fifty males and 50 females were recruited with a mean (± SD) age of 65.1 ± 15.2 years. APACHE II score at admission to ICU was 18.1 ± 7.5 with duration of stay 6.7 ± 6.5days. Self-reported sleep quality score at home (1 = worst; 10 = best) was 7.0 ± 2.2; this decreased to 4.0 ± 1.7 during their stay in ICU (p < 0.001). In multivariate analysis with APACHE III as severity of illness (R(2) = 0.25), factors [exp(b)(95% CI), p value] which significantly affected sleep in ICU were sex [0.37(0.19-0.72), p < 0.01], age and sex interaction [1.02(1.01-1.03), p < 0.01], bedside phone [0.92(0.87-0.97), p < 0.01], prior quality of sleep at home [1.30(1.05-1.62), p = 0.02], and use of steroids [0.82(0.69-0.98), p = 0.03] during the stay in ICU.
Reduced sleep quality is a common problem in ICU with a multifactorial etiology.
睡眠障碍是重症监护病房（ICU）入住患者经常被忽视的并发症。
评估 ICU 入住患者的睡眠质量，并调查影响 ICU 睡眠质量的环境和非环境因素。
在 22 个月的时间里，我们连续招募了在 ICU 中接受气管插管拔出后至少 2 晚并在出院当天对时间、地点和人员有定向的患者。根据改良的 Freedman 问卷收集自我报告的睡眠质量，该问卷提供了 ICU 睡眠质量和影响 ICU 睡眠质量的环境因素的自我报告数据。我们还调查了可能影响睡眠质量的非环境因素，如疾病严重程度、ICU 干预和药物。
共招募了 50 名男性和 50 名女性，平均（±SD）年龄为 65.1±15.2 岁。入住 ICU 时的 APACHE II 评分为 18.1±7.5，入住时间为 6.7±6.5 天。在家中的自我报告睡眠质量评分（1=最差；10=最好）为 7.0±2.2；在 ICU 入住期间，这一评分降至 4.0±1.7（p<0.001）。在以 APACHE III 为疾病严重程度的多变量分析中（R(2)=0.25），在 ICU 中显著影响睡眠的因素[exp(b)(95%CI)，p 值]是性别[0.37(0.19-0.72)，p<0.01]、年龄和性别交互作用[1.02(1.01-1.03)，p<0.01]、床头电话[0.92(0.87-0.97)，p<0.01]、在家中睡眠质量既往史[1.30(1.05-1.62)，p=0.02]和 ICU 入住期间使用类固醇[0.82(0.69-0.98)，p=0.03]。
睡眠质量下降是 ICU 中常见的问题，其病因具有多因素性。
