Improving sleep for the intensive care patient

Not Applicable

Completed

• Conditions: The amount and quality of sleep; Other - Conditions of unknown or disputed aetiology (such as chronic fatigue syndrome/myalgic encephalomyelitis); Public Health - Epidemiology

• Registration Number: ACTRN12610000688088
• Lead Sponsor: niversity of Technology Sydney

Brief Summary

Patients’ median total sleep time was 05:00 (IQR: 02:52 to- 07:14). The majority of sleep was stage 1 and 2 (medians: 19 and 73%) with scant slow wave and REM sleep. The median duration of sleep without waking was 00:03. Sound levels were high (mean Leqeq 53.95 dB(A) during the day and 50.20 dB(A) at night) and illuminance levels were appropriate at night (median <2 lux) but low during the day (median: 74.20 lux). There was a median 1.7 care events/h. Patients’ mean self-reported sleep quality was poor. Interrater reliability of sleep staging was highest for slow wave sleep and lowest for stage 1 sleep. The comparison between the groups' sleep quality and quantity (before and after the implementation of the rest and sleep guideline) revealed no clinically or statistically significant results. The introduction of the Guideline did not appear to result in an improvement in sleep however Guideline uptake was limited. This investigation has revealed the need for alternative methods of analysing ICU patients’ PSG data. The study protocol demonstrates the feasibility of conducting further extensive investigations into potential relationships between patients’ sleep disruption and outcomes. The method in which the Guideline was developed may be of interest to other clinicians wishing to develop guidelines when research evidence is limited.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2010-08-20
• Study Completion: 2011-04-04
• Last Update Posted: 28 June 2021

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 57

Inclusion Criteria

Treated in the intensive care unit (ICU) for 24 hours and likely to be in for a further 48 hours

Exclusion Criteria

History/evidence of sleep disorder, central nervous system impairment e.g. confirmed brain injury on Magnetic Resonance Imaging (MRI)/ Computerised Tomography (CT) scan, diagnosis of dementia

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Total sleep time[A 24 hour sleep period using continuous monitoring]

Secondary Outcome Measures

Name	Time	Method
The number of microarousals defined using the American Academy of Sleep Medicine criteria and assessed by an accredited experienced sleep technologist.<br>Criteria: ' an abrupt shift in electroencephalograph frequency including alpha, theta and/or frequencies >16Hertz (not spindles) that lasts at least 3 seconds, with at least 10 seconds of stable sleep preceding the change. Scoring of arousal during rapid eye movement (REM) sleep requires a concurrent increase in submental electromyography (EMG) lasting at least 1 second.' <br>No adverse events are expected.[24 hour sleep monitoring];Quantity (percentage) of each sleep stage (1 to 4 and Rapid Eye Movement)[A 24 hour sleep period using continuous monitoring]