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Pathophysiology and therapeutic strategy for sleep disturbance in the ICU 

Pathophysiology and therapeutic strategy for sleep disturbance in the ICU
Chapter:
Pathophysiology and therapeutic strategy for sleep disturbance in the ICU
Author(s):

Louise Harder

and Atul Malhotra

DOI:
10.1093/med/9780199600830.003.0225
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date: 25 October 2020

Robust data have shown that sleep disruption and inadequate sleep duration in the general population impact neurocognitive function and produce cardiometabolic sequelae. Despite widespread recognition of the importance of sleep as an essential homeostatic function, there are relatively few data regarding the importance of sleep in critically-ill patients. Obstructive sleep apnoea is a common respiratory condition that is prevalent in the ICU and can be particularly problematic pre-intubation, post-extubation, and in the peri-operative setting. Considerable discussion regarding the impact of sleep versus sedation has occurred, with some insights emerging from improvements in our understanding of basic neurobiology. Sleep disturbance may also have an impact in critically-ill mechanically-ventilated patients by contributing to the development of delirium, which is associated with poor outcomes. However, further data are required to determine the ideal strategy to optimize sleep in the ICU and whether such strategies will in turn improve hard outcomes of critically-ill patients.

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