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Poor Quality of Sleep a Problem In ICU
> 12/11/2007 11:35:27 AM

Patients in the intensive care unit (ICU) generally sleep poorly, getting hardly any of the deep, restorative sleep so important to the healing process. A recent study, which appears in the December edition of The Journal of Trauma: Injury, Infection, and Critical Care, examined the quantity and quality of sleep among patients in an ICU. The researchers found that although the patients received a healthy amount of sleep, the quality of their sleep was inadequate.

The study involved 16 patients at the Parkland Memorial Hospital ICU who had suffered traumatic injuries or undergone surgery two to ten days prior to the beginning of the study. The researchers monitored the patients' brain waves for up to 24 hours and found that the patients received an acceptable amount of sleep in that time period, an average of 8 hours. However, their sleep was disjointed; they woke up an average of six times an hour. Their sleep patterns were also abnormal. A healthy person spends half of their sleep time in stages 3 and 4, and REM sleep. These are the deep, restorative stages of sleep that cause tissue growth, drops in blood pressure, and the recovery of energy. Patients in the ICU, however, spent an average of 96% of their sleep time in stages 1 or 2, the light, superficial stages of sleep. They spent 3.3% of their sleep time in REM sleep and only 0.29% of their sleep time in stages 3 and 4.

The researchers suggest that future studies focus on helping the ICU promote sleep among patients to see if this has an effect on sleep quality. Measures to improve sleep could include removing unnecessary equipment from patients' rooms, ensuring that monitors aren't loud enough to wake patients up, providing patients with eye masks and ear plugs, dimming the lights in patients' rooms, and scheduling caretakers so that patients have longer periods of uninterrupted rest. Future studies should also try to include a larger and more representative sample of ICU patients to better understand how the loss of quality sleep affects patients' health and to determine the most effective ways to improve patients' sleep.

Injury or illness combine with a stressful environment to affect patients' sleep, and researchers should continue to examine ways in which to facilitate high-quality sleep within the ICU. Interruptions in sleep can impact overall health and has negative implications for the immune system. By modifying some ICU practices to help patients sleep better, physicians will also help them to heal faster.

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