Sleep in the intensive care unit

摘要: Abnormalities of sleep are extremely common in critically ill patients, but the mechanisms poorly understood. About half total time occurs during daytime, and circadian rhythm is markedly diminished or lost. Judgments based on inspection consistently overestimate do not detect disruption. Accordingly, reliable polygraphic recordings needed to measure quantity quality patients. Critically patients exhibit more frequent arousals awakenings than normal, decreases rapid eye movement slow wave sleep. The degree fragmentation at least equivalent that seen with obstructive apnea. 20% related noise, 10% patient care activities, cause for remainder known; severity underlying disease likely an important factor. Mechanical ventilation can disruption, precise mechanism has been defined. Sleep disruption induce sympathetic activation elevation blood pressure, which may contribute morbidity. In healthy subjects, deprivation decrease immune function promote negative nitrogen balance. Measures improve include careful attention mode mechanical ventilation, decreasing sedative agents (although latter double-edged swords).