title: Circadian dysrhythmias in the intensive care unit.
abstract: Circadian rhythms underlie nearly all physiologic functions and organ systems. Circadian abnormalities have attendant implications for critical illness survival. The intensive care unit (ICU) environment, with its lack of diurnal variation in sound, light, and social cues, may precipitate circadian dysrhythmias. Additional features of critical care, including mechanical ventilation and sedation, likely perpetuate circadian misalignment. Critical illness itself, from sepsis to severe brain injury, can compromise circadian health. Use of daylight, time-restricted feedings, and administration of melatonin can possibly restore circadian rhythm. However, further study is necessary to assess the effectiveness of these interventions and their impact on ICU outcomes.
authors.affiliation: Division of Pulmonary Critical Care Medicine, UW Medicine Sleep Center at Harborview, University of Washington, 325 Ninth Avenue, Box 359803, Seattle, WA 98104, USA. Electronic address: mebillin@uw.edu.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Billings
authors.affiliation: Department of Neurology, University of Washington, UW Medicine Sleep Center, Seattle, WA 98104, USA.
authors.forename: Nathaniel F
authors.initials: NF
authors.lastname: Watson
mesh_terms: D002492:Central Nervous System Depressants / Q000627:therapeutic use; D021081:Chronobiology Disorders / Q000209:etiology*; D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D008550:Melatonin / Q000627:therapeutic use; D012121:Respiration, Artificial / Q000009:adverse effects; D018805:Sepsis / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000503:physiopathology / Q000628:therapy*
chemical_list: D002492:Central Nervous System Depressants; D008550:Melatonin
keywords: Circadian rhythm; Critical care; Mechanical ventilation; Melatonin