Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers.
Poor sleep affects a majority of critically ill patients and is believed to be associated with adverse intensive care unit (ICU) outcomes such as delirium. While recent guidelines recommend sleep promotion efforts to improve delirium and other ICU outcomes, little is known about critical care providers' beliefs regarding sleep in the ICU.



To evaluate providers' perceptions and practices regarding sleep in the ICU.



From April to July 2014, the Sleep in the ICU Survey was disseminated to ICU providers via institutional e-mail lists and four international critical care society distribution lists.



A total of 1,223 surveys were completed by providers from 24 countries. Respondents were primarily nurses (59%) or physicians (39%). Most respondents indicated that ICU patients experienced "poor" or "very poor" sleep (75%) and that poor sleep could affect the ICU recovery process (88%). Respondents also felt that poor sleep was associated with negative ICU outcomes such as the development of delirium (97%), longer length of stay (88%), poor participation in physical therapy (87%), and delayed liberation from mechanical ventilation (83%). The minority (32%) of providers had sleep-promoting protocols; these providers tended to believe their patients slept longer and experienced better sleep quality.



Though most clinicians believe that sleep in the ICU is poor and adversely affects patient outcomes, a minority of the ICUs represented by our respondents have sleep promotion protocols. These findings highlight discordant provider perceptions and practices surrounding sleep in the ICU, as well as a possible lack of available evidence-based guidelines for promoting sleep in the ICU.
1 Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California.
Biren B
0000-0002-9245-6229
BB
Kamdar
2 Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
Melissa P
0000-0002-7341-850X
MP
Knauert
3 Division of Pulmonary, Critical Care and Sleep Medicine, Baylor Scott and White Healthcare, Texas A&M Health Science Center College of Medicine, Temple, Texas.
Shirley F
0000-0001-8637-0317
SF
Jones
4 Division of Pulmonary and Critical Care Medicine, VA Puget Sound Health Care System, University of Washington, Seattle, Washington; and.
Elizabeth C
0000-0001-8862-8123
EC
Parsons
5 Division of Pulmonary and Critical Care Medicine, University of Arizona, Tucson, Arizona.
Sairam
0000-0002-1128-3005
S
Parthasarathy
2 Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
Margaret A
0000-0001-8601-7038
MA
Pisani
D000328:Adult; D016638:Critical Illness / Q000523:psychology* / Q000628:therapy; D003693:Delirium / Q000209:etiology; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D007391:International Cooperation; D020407:Internet; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012890:Sleep
critical care; delirium; healthcare survey; intensive care unit; sleep