title: Sleep in the intensive care unit.
abstract: Poor sleep quality is a consistently reported by patients in the ICU. In such a potentially hostile environment, sleep is extremely fragmented and sleep architecture is unconventional, with a predominance of superficial sleep stages and a limited amount of time spent in the restorative stages. Among the causes of sleep disruption in the ICU are factors intrinsic to the patients and the acute nature of their condition, as well as factors related to the ICU environment and the treatments administered, such as mechanical ventilation and drug therapy. Although the consequences of poor sleep quality for the recovery of ICU patients remain unknown, it seems to influence the immune, metabolic, cardiovascular, respiratory, and neurological systems. There is evidence that multifaceted interventions focused on minimizing nocturnal sleep disruptions improve sleep quality in ICU patients. In this article, we review the literature regarding normal sleep and sleep in the ICU. We also analyze sleep assessment methods; the causes of poor sleep quality and its potential implications for the recovery process of critically ill patients; and strategies for sleep promotion.
authors.affiliation: Programa de Pós-Graduação de Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Flávia Gabe
authors.initials: FG
authors.lastname: Beltrami
authors.affiliation: Unité de Somnologie et Fonction Respiratoire, Département de Physiologie Respiratoire et Sommeil, Hôpital Saint-Antoine, Paris, France.
authors.forename: Xuân-Lan
authors.initials: XL
authors.lastname: Nguyen
authors.affiliation: Service de Réanimation Médicale, Hôpital Saint-Antoine, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Pichereau
authors.affiliation: Service de Réanimation Médicale, Hôpital Saint-Antoine, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Maury
authors.affiliation: Collège de Médecine des Hôpitaux de Paris, Département de Physiologie Respiratoire et Sommeil, Hôpital Saint-Antoine, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Fleury
authors.affiliation: Programa de Pós-Graduação de Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Simone
authors.initials: S
authors.lastname: Fagondes
mesh_terms: D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D017286:Polysomnography; D012307:Risk Factors; D012892:Sleep Deprivation / Q000145:classification / Q000209:etiology* / Q000503:physiopathology