title: Delirium: is sleep important?
abstract: Delirium and poor sleep quality are common and often co-exist in hospitalised patients. A link between these disorders has been hypothesised but whether this link is a cause-and-effect relationship or simply an association resulting from shared mechanisms is yet to be determined. Potential shared mechanisms include: abnormalities of neurotransmitters, tissue ischaemia, inflammation and sedative exposure. Sedatives, while decreasing sleep latency, often cause a decrease in slow wave sleep and stage rapid eye movement (REM) sleep and therefore may not provide the same restorative properties as natural sleep. Mechanical ventilation, an important cause of sleep disruption in intensive care unit (ICU) patients, may lead to sleep disruption not only from the discomfort of the endotracheal tube but also as a result of ineffective respiratory efforts and by inducing central apnoea events if not properly adjusted for the patient's physiologic needs. When possible, efforts should be made to optimise the patient-ventilator interaction to minimise sleep disruptions.
authors.affiliation: Department of Medicine, Division of Allergy, Pulmonary, Critical Care and Sleep Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. paula.l.watson@vanderbilt.edu
authors.forename: Paula L
authors.initials: PL
authors.lastname: Watson
authors.forename: Piero
authors.initials: P
authors.lastname: Ceriana
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfulla
mesh_terms: D003693:Delirium / Q000150:complications / Q000209:etiology* / Q000517:prevention & control; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology / Q000627:therapeutic use; D007362:Intensive Care Units; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods; D012892:Sleep Deprivation / Q000150:complications / Q000209:etiology* / Q000517:prevention & control; D012893:Sleep Wake Disorders / Q000150:complications / Q000209:etiology* / Q000517:prevention & control; D012895:Sleep, REM / Q000502:physiology
chemical_list: D006993:Hypnotics and Sedatives