![]() 8, 13, 14 The greatest disruptions are noted with reductions in deep and rapid eye movement (REM) sleep stages, which are considered the most restorative stages. 12 Several studies have used polysomnography to examine the quantity and quality of sleep in the ICU and found that although patients do achieve some restorative sleep, their sleep is often fragmented. 11 Delirium may also affect circadian rhythm cycles, but its overall impact on sleep remains controversial. 8– 10 Mechanical ventilation may worsen sleep fragmentation and circadian rhythm, but these effects have not yet been well established in the literature. ![]() ![]() 8– 10 Moreover, these patients experience increased sleep fragmentation, daytime sleeping, and longer periods of light sleep compared with healthy adults. 2 However, subjective sleep quality may be reduced in critically ill patients. 2 In most cases, critically ill patients and healthy adults have similar total sleep time. Sleep deprivation may be a consequence of inadequate amounts of sleep or poor sleep quality. 2 These guidelines offer clear, actionable evidence to guide current clinical practice with regard to sleep deprivation in the ICU setting. 5 In 2018, the Society of Critical Care Medicine issued updated clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU, commonly referred to as the PADIS guidelines. 2, 4 Factors associated with sleep deprivation in the ICU include noise, light, patient-ventilator dyssynchrony, medication effects, and frequent care activities. 2, 3 Critically ill patients have increased incidences of reduced sleep efficiency, sleep fragmentation, reduced restorative sleep, and frequent night awakenings. 1 Sleep deprivation is associated with emotional distress and has also been theorized to contribute to immune system compromise, cognitive problems, muscular complications, respiratory abnormalities, and prolonged mechanical ventilation. Sleep deprivation is a harmful yet common condition among intensive care unit (ICU) patients. ![]()
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