ICU Literature Updates from November 2014

Delirium Transitions in the Medical ICU: Exploring the Role of Sleep Quality and Other Factors

Written by one of the more productive groups in the field, the authors evaluated the link of perceived sleep quality ratings along with other patient and ICU risk factors with the development of delirium on a daily basis in 223 medical ICU patients over a 201 day period. Interestingly, the author’s found no association between daily perceived sleep quality ratings and transition to delirium. As reported in other publications, the authors found infusion of benzodiazepines and opioids in mechanically ventilated patients as risk factors for the development of delirium.

Sleep in the Intensive Care Unit: A Review

In this article, the authors review and update the reader on what is currently known with regards to staging and measuring sleep. It offers a nice review on the characteristics of sleep in the ICU. There is a very nice section of sleep deprivation and immune function. Most of the article focuses on causes of abnormal sleep in the ICU and reviews much of what is already known. It concludes with a nice review of how to promote sleep in the ICU.

Sleep Disturbance in Older ICU Patients

In this study, the authors note aging is associated with specific changes to both the quantity and quality of sleep and that these changes make it hard to adjust sleep and wake rhythms to changing environmental conditions. In the context of the ICU, an environment already known to alter sleep, the authors evaluated sleep in patients admitted to the ICU who were older than age 80. The authors reviewed four studies on sleep in the elderly. This study was helpful in bring much of the resaerch of sleep in elderly ICU patients into one location. However, much is still needed in the study of sleep in this frail and vulnerable population.