van der Hoeven Adrienne E, Fronczek Rolf, Bijlenga Denise, Hadra Sarah, Ridder Caro, Henneman Marlies, Maas Jessica A, Goedemans-de Graaf Suzanna A, Lammers Gert Jan, van Westerloo David J, Schinkelshoek Mink S
Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
Stichting Epilepsie Instellingen Nederland, Sleep-Wake Center, Heemstede, the Netherlands.
Nurs Crit Care. 2025 Jul;30(4):e70106. doi: 10.1111/nicc.70106.
Vivid dream experiences in the intensive care unit (ICU) are common, but poorly understood.
We investigated the occurrence, vividness, content, emotional impact and associated factors of dream experiences in the ICU.
Retrospective mixed methods study with subjects ≥ 18 years, previously admitted to the ICU for ≥ 4 days and/or due to COVID-19, who were not sedated for ≥ 24 h during their stay (n = 80). Participants answered a retrospective questionnaire by telephone. Clinical data were collected from electronic health records.
The questionnaires were taken a median of 9 months post-discharge. Dream experiences were reported by 79%. Of participants who recollected dream experiences, 73% reported "life-like" dreams, 49% associated their dreams with negative emotions and 54% said their dreams impacted them even after awaking. Some participants (28.6%) continued to have similar dreams at home. After being asked if they had additional comments, some participants suggest receiving information during their hospital stay about the potential for vivid dream experiences could be beneficial. The dream content was often related to the ICU admission. Younger age and longer length of stay were related to vivid dream experiences. Of participants with dream experiences 62.5% had experienced delirium during their ICU stay. Perceptual disturbances were also frequently reported by participants (50%) and only 45% could clearly distinguish them from dream experiences. There was an overlap between participants reporting perceptual disturbances and confirmed delirium (70%).
Vivid dream experiences are common in ICU patients and often have a negative emotional impact. Future studies should dive deeper into effective ways to distinguish dreams, delirium and perceptual disturbances and how to reduce their impact.
ICU nurses should be aware of the occurrence and psychological burden of vivid negative dreams in ICU patients. Providing anticipatory support may help patients process these experiences during recovery.
重症监护病房（ICU）中的逼真梦境体验很常见，但人们对此了解甚少。
我们调查了ICU中梦境体验的发生率、逼真程度、内容、情感影响及相关因素。
采用回顾性混合方法研究，研究对象为年龄≥18岁、曾因新冠疫情在ICU住院≥4天和/或入住ICU的患者，住院期间未接受≥24小时镇静治疗（n = 80）。参与者通过电话回答一份回顾性问卷。临床数据从电子健康记录中收集。
问卷在出院后中位数9个月时进行。79%的人报告有梦境体验。在回忆起梦境体验的参与者中，73%报告梦境“栩栩如生”，49%的人认为他们的梦境与负面情绪有关，54%的人表示他们的梦境即使在醒来后仍对他们有影响。一些参与者（28.6%）在家中仍会继续做类似的梦。在被问及是否有其他意见时，一些参与者建议在住院期间获得有关逼真梦境体验可能性的信息可能会有所帮助。梦境内容通常与入住ICU有关。年龄较小和住院时间较长与逼真的梦境体验有关。在有梦境体验的参与者中，62.5%在ICU住院期间经历过谵妄。参与者也经常报告有感知障碍（50%），只有45%的人能清楚地将其与梦境体验区分开来。报告有感知障碍的参与者与确诊谵妄的参与者之间存在重叠（70%）。
逼真的梦境体验在ICU患者中很常见，并且通常会产生负面情绪影响。未来的研究应更深入地探讨区分梦境、谵妄和感知障碍的有效方法，以及如何减少它们的影响。
ICU护士应意识到ICU患者中逼真负面梦境的发生情况及其心理负担。提供预期性支持可能有助于患者在康复过程中处理这些体验。
