title: Evaluation of patients' sleep by nurses in an ICU.
abstract: OBJECTIVE
  To determine how intensive care unit evaluations of patients' sleep by nurses correspond to polysomnography and if changes in patients' physiologic parameters could be helpful in sleep evaluation.
  
  
  BACKGROUND
  The evaluations of patients' sleep by nurses have not corresponded very well with objective sleep recordings, so there is a need for further knowledge in this field.
  
  
  METHODS
  Correlational study of patients' sleep, nurses' sleep evaluations and the sleep-related heart rate and blood pressure changes.
  
  
  METHODS
  The standard overnight polysomnography was recorded on 21 patients. Simultaneously, nurses marked into an electronic patient care documentation system all the changes noted in the patients' sleep status. Patients' arterial blood pressure and heart-rate data were automatically saved into the electronic patient care documentation.
  
  
  RESULTS
  The evaluations of patients' sleep/wake state by nurses corresponded to polysomnography 68% of the time. A correlation was found between nurses' evaluations and polysomnography recordings only on total sleep time. There was no correlation in the other sleep aspects (sleep latency, amount of awakenings or movements during sleep). Most patients' blood pressures and heart rate varied according to sleep/wake state. There was less variation if the patient had received noradrenalin for blood pressure control.
  
  
  CONCLUSIONS
  The evaluations of patients' sleep/wake state by nurses only correspond to the polysomnography two-thirds of the time. Thus, more sophisticated evaluation methods should be developed to aid nurses in sleep evaluations. Sleep-related changes in blood pressure and heart rate can be seen in intensive care unit patients, so using these parameters as part of the patients' sleep evaluation should be further explored.
  
  
  CONCLUSIONS
  The nurses' evaluation practices of intensive care unit patients' sleep need further development. Monitoring the changes in patients' heart rate and blood pressure may aid in evaluating his/her sleep.
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.|HUCH Perioperative, Intensive Care and Pain Medicine, Critical Care Clinic, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Marita
authors.initials: M
authors.lastname: Ritmala-Castren
authors.affiliation: Department of Clinical Neurophysiology, Turku University Hospital, Turku, Finland.|Sleep Research Unit, University of Turku, Turku, Finland.
authors.forename: Irina
authors.initials: I
authors.lastname: Virtanen
authors.affiliation: Department of Biostatistics, University of Turku, Turku, Finland.
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.affiliation: Department of Clinical Neurophysiology, Turku University Hospital, Turku, Finland.
authors.forename: Sanna
authors.initials: S
authors.lastname: Leivo
authors.affiliation: HUCH Perioperative, Intensive Care and Pain Medicine, Critical Care Clinic, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Kirsi-Maija
authors.initials: KM
authors.lastname: Kaukonen
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.|Turku University Hospital, Turku, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
mesh_terms: D000328:Adult; D016638:Critical Illness / Q000451:nursing*; D005260:Female; D006339:Heart Rate; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000379:methods; D009733:Nursing Diagnosis / Q000379:methods*; D017286:Polysomnography / Q000451:nursing*; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000451:nursing
keywords: critical care; intensive care; nursing assessment; physiological responses; sleep; sleep quality