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Semin Respir Crit Care Med 2019; 40(05): 614-628
DOI: 10.1055/s-0039-1698378
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sleep in the Intensive Care Unit: Strategies for Improvement

Jennifer J. Dorsch
1   Department of Medicine, Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, Maryland
,
Jennifer L. Martin
2   Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles
3   Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California
,
Atul Malhotra
4   Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego
,
Robert L. Owens
4   Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego
,
Biren B. Kamdar
4   Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego
› Author Affiliations
Funding B.B.K. is currently supported by a Paul B. Beeson Career Development Award through the National Institutes of Health/National Institute on Aging (K76AG059936). J.L.M. is supported by the National Institutes of Health/National Heart Lung and Blood Institute (K24 HL143055).
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Publication History

Publication Date:
11 December 2019 (online)

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Abstract

Sleep in the intensive care unit (ICU) is considered to be subjectively poor, highly fragmented, and sometimes referred to as “atypical.” Although sleep is felt to be crucial for patient recovery, little is known about the association of sleep with physiologic function among critically ill patients, or those with clinically important outcomes in the ICU. Research involving ICU-based sleep disturbance is challenging due to the lack of objective, practical, reliable, and scalable methods to measure sleep and the multifactorial etiologies of its disruption. Despite these challenges, research into sleep-promoting techniques is growing and has demonstrated a variety of causes leading to ICU-related sleep loss, thereby motivating multifaceted intervention efforts. Through a focused review of (1) sleep measurement in the ICU; (2) outcomes related to poor sleep in the ICU; and (3) ICU-based sleep promotion efforts including environmental, nonpharmacological, and pharmacological interventions, this paper examines research regarding sleep in the ICU and highlights the need for future investigation into this complex and dynamic field.

Keywords

sleep - intensive care - critical care - delirium