ICU patients not getting enough sleep time to heal

December 10th, 2007 - 3:21 pm ICT by admin  

Washington, Dec 10 (ANI): A study has found that the sleep patterns of the Intensive Care Unit (ICU) patients are superficial, i.e. the patients barely spend any time in the restorative stages of sleep that aid in healing.

The study, led by Dr. Randall Friese, assistant professor of burn/trauma/critical care at UT Southwestern, found that ICU patients might look like that they are sleeping, but they are not sleeping well.

Current clinical-care protocols routinely and severely deprive critically ill patients of sleep at a time when the need for adequate rest is perhaps most essential, said Friese.

We havent recognized the importance of prescribing sleep, patients in the ICU may look like they are sleeping, but theyre not sleeping well. They are not getting the restorative stages that are required, added Friese.

Sleep typically occurs at night in successive cyclical stages. It begins in very superficial stages. These stages are followed by deeper, more restorative states, including rapid eye movement (REM) sleep.

In the study, the researcher monitored the sleep patterns of 16 patients in the ICU who had suffered traumatic injuries or had undergone intra-abdominal surgical procedures.

The patients had been in the ICU two to 10 days. Patients suffering brain injuries were excluded from the study because such injuries typically illicit abnormal sleep patterns.

After monitoring the patients brain waves in a specially equipped bed for up to 24 hours, Friese found that patients in the ICU received an acceptable amount of sleep time, but that the sleep patterns were fragmented and significantly abnormal.

Patients in the ICU spent 96 percent of their sleep cycle in superficial stages, compared to normal sleep, in which up to 50 percent is spent in the restorative stages.

Friese said that the next step is to design a clinical trial that makes the ICU environment more conducive to sleep and then monitor the patients outcomes.

Some proposed steps to decrease disturbances in the ICU include adjusting monitoring machines so that alarms dont wake up sleeping patients, providing patients ear plugs and eye shields, dimming the lights, and using pharmacological sleeping aids.

There are two major things contributing to abnormal sleep in these patients the pathophysiology of the disease process itself and the stressful environment of the ICU, Friese said.

If we can neutralize the stressful environment, maybe we can shorten the hospital stay, lower infection risks and increase patient wound healing, Friese added.

Dr. Ramon Diaz-Arrastia, professor of neurology and one of the studys authors, said the investigation demonstrated that surgical patients in the ICU have essentially no restorative sleep.

Restorative sleep is most abundant during the later part of sleep it is sometime between 3 a.m. to 6 a.m. that the bulk of this stage of sleep occurs. It is likely that with some straightforward measures, such as changing the schedule of nursing intervention, we may help these patients attain the restorative sleep that could improve their outcomes, Diaz-Arrastia said.

The study is published in The Journal of Trauma: Injury, Infection and Critical Care. (ANI)

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