title: Sleep disturbance in older ICU patients.
abstract: Maintaining a stable and adequate sleeping pattern is associated with good health and disease prevention. As a restorative process, sleep is important for supporting immune function and aiding the body in healing and recovery. Aging is associated with characteristic changes to sleep quantity and quality, which make it more difficult to adjust sleep-wake rhythms to changing environmental conditions. Sleep disturbance and abnormal sleep-wake cycles are commonly reported in seriously ill older patients in the intensive care unit (ICU). A combination of intrinsic and extrinsic factors appears to contribute to these disruptions. Little is known regarding the effect that sleep disturbance has on health status in the oldest of old (80+), a group, who with diminishing physiological reserve and increasing prevalence of frailty, is at a greater risk of adverse health outcomes, such as cognitive decline and mortality. Here we review how sleep is altered in the ICU, with particular attention to older patients, especially those aged ≥80 years. Further work is required to understand what impact sleep disturbance has on frailty levels and poor outcomes in older critically ill patients.
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada ; Division of Geriatric Medicine, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Sterniczuk
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada ; Department of Psychiatry, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rusak
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D016330:Frail Elderly; D006304:Health Status; D006801:Humans; D007362:Intensive Care Units; D015995:Prevalence; D020178:Sleep Disorders, Circadian Rhythm / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control
keywords: aging; frailty; intensive care unit; sleep; wake rhythm