title: Half of the family members of critically ill patients experience excessive daytime sleepiness.
abstract: BACKGROUND
  Sleepiness and fatigue are commonly reported by family members of intensive care unit (ICU) patients. Sleep deprivation may result in cognitive deficits. Sleep deprivation and cognitive blunting have not been quantitatively assessed in this population. We sought to determine the proportion of family members of ICU patients that experience excessive daytime sleepiness, sleep-associated functional impairment, and cognitive blunting.
  
  
  METHODS
  Multicenter, cross-sectional survey of family members of patients admitted to ICUs at the University of Maryland Medical Center, Johns Hopkins University Hospital, and Christiana Hospital. Family members of ICU patients were evaluated using the Epworth Sleepiness Scale, a validated survey assessing sleepiness in everyday situations (normal, less than 10); the Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), a questionnaire quantifying the impact of sleepiness on daily activities (normal, at least 17.9); and psychomotor vigilance testing, a test of cognitive function, in relation to sleep deprivation (normal mean reaction time less than 500 ms).
  
  
  RESULTS
  A total of 225 family members were assessed. Of these, 50.2 % (113/225) had Epworth scores consistent with excessive daytime sleepiness. Those with sleepiness experienced greater impairment in performing daily activities by FOSQ-10 (15.6 ± 3.0 vs 17.4 ± 2.2, p < 0.001). Cognitive blunting was found in 13.3 % (30/225) of family members and 15.1 % (14/93) of surrogate decision-makers. Similar rates of cognitive blunting as reported by mean reaction time of at least 500 ms were found among family members whether or not they reported sleepiness (15.0 % (17/113) vs. 11.6 % (13/112), p = 0.45).
  
  
  CONCLUSIONS
  Half of the family members of ICU patients suffer from excessive daytime sleepiness. This sleepiness is associated with functional impairment, but not cognitive blunting.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, 110 S. Paca St., Second Floor, Baltimore, MD, 21201, USA, Avercele@medicine.umaryland.edu.
authors.forename: Avelino C
authors.initials: AC
authors.lastname: Verceles
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Corwin
authors.forename: Majid
authors.initials: M
authors.lastname: Afshar
authors.forename: Eliot B
authors.initials: EB
authors.lastname: Friedman
authors.forename: Michael T
authors.initials: MT
authors.lastname: McCurdy
authors.forename: Carl
authors.initials: C
authors.lastname: Shanholtz
authors.forename: Karen
authors.initials: K
authors.lastname: Oakjones
authors.forename: Marc T
authors.initials: MT
authors.lastname: Zubrow
authors.forename: Jennifer
authors.initials: J
authors.lastname: Titus
authors.forename: Giora
authors.initials: G
authors.lastname: Netzer
mesh_terms: D016638:Critical Illness; D003430:Cross-Sectional Studies; D003625:Data Collection; D005190:Family; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012894:Sleep Stages