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Sleep disturbances in critically ill patients 

Sleep disturbances in critically ill patients
Sleep disturbances in critically ill patients

Gerald L. Weinhouse

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date: 29 November 2020

This chapter reviews the numerous reasons why critically ill patients often sleep poorly and describes the unique challenges of monitoring sleep in these patients. An inhospitable environment in the intensive care unit (ICU), care-related interruptions day and night, mechanical ventilation, numerous medications, and critical illness itself conspire to deprive these vulnerable patients of both deep NREM sleep and REM sleep. Under some conditions, sleep is so disturbed as to be almost unrecognizable by the Rechtschaffen & Kales criteria. Patients may suffer from “atypical sleep” or from “pathological wakefulness.” Patients often recall this poor sleep as one of their most stressful experiences while in the ICU. Ultimately, what may best restore good quality sleep for patients in the ICU is a multifaceted approach to creating a quiet, safe environment, combined with evidence-based management of medications, support devices, pain, and delirium and a conscious effort to set aside uninterrupted time for sleep.

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