title: Sleep in the intensive care unit.
abstract: Sleep is an important physiologic process, and lack of sleep is associated with a host of adverse outcomes. Basic and clinical research has documented the important role circadian rhythm plays in biologic function. Critical illness is a time of extreme vulnerability for patients, and the important role sleep may play in recovery for intensive care unit (ICU) patients is just beginning to be explored. This concise clinical review focuses on the current state of research examining sleep in critical illness. We discuss sleep and circadian rhythm abnormalities that occur in ICU patients and the challenges to measuring alterations in circadian rhythm in critical illness and review methods to measure sleep in the ICU, including polysomnography, actigraphy, and questionnaires. We discuss data on the impact of potentially modifiable disruptors to patient sleep, such as noise, light, and patient care activities, and report on potential methods to improve sleep in the setting of critical illness. Finally, we review the latest literature on sleep disturbances that persist or develop after critical illness.
authors.affiliation: 1 Department of Internal Medicine, Pulmonary, Critical Care & Sleep Division, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Pisani
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Brian K
authors.initials: BK
authors.lastname: Gehlbach
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Schwab
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Weinhouse
authors.forename: Shirley F
authors.initials: SF
authors.lastname: Jones
mesh_terms: D056044:Actigraphy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D035843:Biomedical Research; D002940:Circadian Rhythm / Q000502:physiology*; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation / Q000175:diagnosis* / Q000628:therapy*; D055815:Young Adult
keywords: circadian rhythm; critical illness; polysomnography; sleep disruption