Sleep in critically ill, mechanically ventilated patients with severe sepsis or COPD

Y Boyko, P Jennum, H Oerding, J T Lauridsen, M Nikolic, P Toft

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: The standard method for scoring polysomnographic (PSG) sleep is insufficient in the intensive care unit (ICU). A modified classification has been proposed, but has not been tested in specific groups of ICU patients. We aimed firstly to (1) use the modified classification to describe sleep in two groups of ICU patients: a severe sepsis group and a chronic obstructive pulmonary disease (COPD) group, and (2) to compare sleep stage distribution in the groups; secondly to compare the PSG findings with nurses’ sleep evaluation. Methods: Non-sedated mechanically ventilated patients with severe sepsis or COPD completed up to 20-hours PSG recording in each patient. A modified classification for scoring sleep in ICU was used for scoring the PSGs. Sleep assessment by nurses was done at 15 minutes intervals. Results: We included 16 patients with severe sepsis and 17 patients with COPD. Half of the patients in the severe sepsis group and 59% in the COPD group had atypical sleep. We found significantly different sleep stage distribution in the two groups, with the COPD group having a higher proportion of atypical sleep (54.4% vs 48.7%, P <.0001). No correlation between nurse sleep assessment and PSG was found in cases of atypical sleep (P <.0001). Conclusion: Normal PSG sleep characteristics as defined by standard classification are absent in many conscious, non-sedated critically ill patients on mechanical ventilation. Nurse sleep evaluation does not correlate with PSG if atypical sleep is present in the PSG, which limits the reliability of subjective sleep assessment in this patient population.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Volume62
Issue number8
Pages (from-to)1120-1126
ISSN0001-5172
DOIs
Publication statusPublished - 2018

Fingerprint

Critical Illness
Chronic Obstructive Pulmonary Disease
Intensive Care Units
Nurses
Research Design

Keywords

  • atypical sleep
  • chronic obstructive pulmonary disease
  • polysomnography
  • severe sepsis
  • sleep pattern

Cite this

@article{fd07da78a8ca47d5a2f37b73d7d0f712,
title = "Sleep in critically ill, mechanically ventilated patients with severe sepsis or COPD",
abstract = "Background: The standard method for scoring polysomnographic (PSG) sleep is insufficient in the intensive care unit (ICU). A modified classification has been proposed, but has not been tested in specific groups of ICU patients. We aimed firstly to (1) use the modified classification to describe sleep in two groups of ICU patients: a severe sepsis group and a chronic obstructive pulmonary disease (COPD) group, and (2) to compare sleep stage distribution in the groups; secondly to compare the PSG findings with nurses’ sleep evaluation. Methods: Non-sedated mechanically ventilated patients with severe sepsis or COPD completed up to 20-hours PSG recording in each patient. A modified classification for scoring sleep in ICU was used for scoring the PSGs. Sleep assessment by nurses was done at 15 minutes intervals. Results: We included 16 patients with severe sepsis and 17 patients with COPD. Half of the patients in the severe sepsis group and 59{\%} in the COPD group had atypical sleep. We found significantly different sleep stage distribution in the two groups, with the COPD group having a higher proportion of atypical sleep (54.4{\%} vs 48.7{\%}, P <.0001). No correlation between nurse sleep assessment and PSG was found in cases of atypical sleep (P <.0001). Conclusion: Normal PSG sleep characteristics as defined by standard classification are absent in many conscious, non-sedated critically ill patients on mechanical ventilation. Nurse sleep evaluation does not correlate with PSG if atypical sleep is present in the PSG, which limits the reliability of subjective sleep assessment in this patient population.",
keywords = "atypical sleep, chronic obstructive pulmonary disease, polysomnography, severe sepsis, sleep pattern",
author = "Y Boyko and P Jennum and H Oerding and Lauridsen, {J T} and M Nikolic and P Toft",
note = "{\circledC} 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",
year = "2018",
doi = "10.1111/aas.13140",
language = "English",
volume = "62",
pages = "1120--1126",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell",
number = "8",

}

Sleep in critically ill, mechanically ventilated patients with severe sepsis or COPD. / Boyko, Y; Jennum, P; Oerding, H; Lauridsen, J T; Nikolic, M; Toft, P.

In: Acta Anaesthesiologica Scandinavica, Vol. 62, No. 8, 2018, p. 1120-1126.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Sleep in critically ill, mechanically ventilated patients with severe sepsis or COPD

AU - Boyko, Y

AU - Jennum, P

AU - Oerding, H

AU - Lauridsen, J T

AU - Nikolic, M

AU - Toft, P

N1 - © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2018

Y1 - 2018

N2 - Background: The standard method for scoring polysomnographic (PSG) sleep is insufficient in the intensive care unit (ICU). A modified classification has been proposed, but has not been tested in specific groups of ICU patients. We aimed firstly to (1) use the modified classification to describe sleep in two groups of ICU patients: a severe sepsis group and a chronic obstructive pulmonary disease (COPD) group, and (2) to compare sleep stage distribution in the groups; secondly to compare the PSG findings with nurses’ sleep evaluation. Methods: Non-sedated mechanically ventilated patients with severe sepsis or COPD completed up to 20-hours PSG recording in each patient. A modified classification for scoring sleep in ICU was used for scoring the PSGs. Sleep assessment by nurses was done at 15 minutes intervals. Results: We included 16 patients with severe sepsis and 17 patients with COPD. Half of the patients in the severe sepsis group and 59% in the COPD group had atypical sleep. We found significantly different sleep stage distribution in the two groups, with the COPD group having a higher proportion of atypical sleep (54.4% vs 48.7%, P <.0001). No correlation between nurse sleep assessment and PSG was found in cases of atypical sleep (P <.0001). Conclusion: Normal PSG sleep characteristics as defined by standard classification are absent in many conscious, non-sedated critically ill patients on mechanical ventilation. Nurse sleep evaluation does not correlate with PSG if atypical sleep is present in the PSG, which limits the reliability of subjective sleep assessment in this patient population.

AB - Background: The standard method for scoring polysomnographic (PSG) sleep is insufficient in the intensive care unit (ICU). A modified classification has been proposed, but has not been tested in specific groups of ICU patients. We aimed firstly to (1) use the modified classification to describe sleep in two groups of ICU patients: a severe sepsis group and a chronic obstructive pulmonary disease (COPD) group, and (2) to compare sleep stage distribution in the groups; secondly to compare the PSG findings with nurses’ sleep evaluation. Methods: Non-sedated mechanically ventilated patients with severe sepsis or COPD completed up to 20-hours PSG recording in each patient. A modified classification for scoring sleep in ICU was used for scoring the PSGs. Sleep assessment by nurses was done at 15 minutes intervals. Results: We included 16 patients with severe sepsis and 17 patients with COPD. Half of the patients in the severe sepsis group and 59% in the COPD group had atypical sleep. We found significantly different sleep stage distribution in the two groups, with the COPD group having a higher proportion of atypical sleep (54.4% vs 48.7%, P <.0001). No correlation between nurse sleep assessment and PSG was found in cases of atypical sleep (P <.0001). Conclusion: Normal PSG sleep characteristics as defined by standard classification are absent in many conscious, non-sedated critically ill patients on mechanical ventilation. Nurse sleep evaluation does not correlate with PSG if atypical sleep is present in the PSG, which limits the reliability of subjective sleep assessment in this patient population.

KW - atypical sleep

KW - chronic obstructive pulmonary disease

KW - polysomnography

KW - severe sepsis

KW - sleep pattern

U2 - 10.1111/aas.13140

DO - 10.1111/aas.13140

M3 - Journal article

C2 - 29687438

VL - 62

SP - 1120

EP - 1126

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 8

ER -