Comprehensive Assessment of Night time sleep in Conscious Guillain Barré syndrome GBS patients in Intensive Care Unit ICU. A Prospective Observational Study

Sleep is defined as a periodic, reversible state of disengagement and insensitivity from the environment. Although the sleep has a primary function of restorative process that aid in cognitive functioning, it also plays a pivotal role in metabolic conservation and produces an anabolic state. Sleep is a circadian phenomena. The most predominant factor that effect this cycle is light/dark cycle as melatonin, sleep promoting hormone is produced maximal at night. In the ICU setting disturbed sleep is multifactorial that can present with various adverse consequences, like cognitive impairment, depression, poor outcome, reduced host immunity, attenuated ventilatory response to hypoxemia and hypercapnia, increased carbon dioxide production. This in turn leads to difficulty in liberation from mechanical ventilation, and increased morbidity.  Around 30% of  GBS patients present with respiratory failure requiring ventilation and ICU admission. The mechanism of Sleep disturbance in GBS patients is attributed to involvement of lateral hypothalamus where blood-brain-barrier is exposed to antibodies, disruption in corollary discharge system, underlying stress and anxiety, proinflammatory cytokines causing neurotransmitter dysfunction, and autonomic dysfunction. Although disturbed sleep has adverse consequences, it is more recently it has taken place in ICU care and neuro-rehabilitation. There is limited data available on qualitative sleep assessment in GBS patients admitted to the ICU, we intend to conduct the study to assess the burden sleep disturbance in GBS patients, and identify the risk factors affecting the sleep during the ICU stay, and on long term sleep quality using EEG, and sleep questionnaire