Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive cave unit
Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive cave unit
复制标题
DOI：
10.1164/ajrccm.163.2.9912128
复制
发表时间：
2001-02-01
影响因子：
24.7
通讯作者：
Schwab, RJ
中科院分区：
文献类型：
--
作者：
Freedman, NS;Gazendam, J;Schwab, RJ
对重症监护中的睡眠/觉醒异常知之甚少，对这些异常的机制也知之甚少。我们研究了22例（20例机械通气）重症监护病房（ICU）患者，连续多导睡眠图（PSC）和环境噪声测量24-48小时，以表征睡眠-觉醒模式，并客观地确定环境噪声对睡眠中断的影响。所有22例患者均表现出睡眠-觉醒周期异常。总睡眠时间（TST）存在较大差异，每24小时研究期间的平均总睡眠时间为8.8 +/- 5.0小时。睡眠-觉醒周期是碎片化和非巩固的，平均57 +/- 18%和43 +/- 18%的TST分别发生在白天和夜间。环境噪声分别占总觉醒和从睡眠中醒来的11.5%和17%。平均噪声唤醒指数为1.9 +/- 2.1次唤醒/h睡眠。结论：（1）ICU患者存在定性睡眠剥夺，但不一定是定量睡眠剥夺;（2）尽管环境噪声部分导致睡眠-觉醒异常，但与大多数睡眠碎片无关，因此可能不像以前的文献所建议的那样对睡眠造成破坏。
Little is known about sleep/wake abnormalities in intensive care and less is known about the mechanisms responsible for these abnormalities. We studied 22 (20 mechanically ventilated) medical intensive care unit (ICU) patients with continuous polysomnography (PSC) and environmental noise measurements for 24-48 h to characterize sleep-wake patterns and objectively determine the effect of environmental noise on sleep disruption. All 22 patients demonstrated sleep-wake cycle abnormalities. There were large variations in total sleep time (TST) with the mean total sleep time per 24-h study period of 8.8 +/- 5.0 h. Sleep-wake cycles were fragmented and nonconsolidated with a mean of 57 +/- 18% and 43 +/- 18% of the TST occurring during the day and night, respectively. Environmental noise was responsible for 11.5 and 17% of the overall arousals and awakenings from sleep, respectively. The mean noise arousal index was 1.9 +/- 2.1 arousals/h sleep, Conclusions: (1) ICU patients are qualitatively, but not necessarily quantitatively, sleep deprived; and (2) although environmental noise is in part responsible for sleep-wake abnormalities, it is not responsible for the majority of the sleep fragmentation and may therefore not be as disruptive to sleep as the previous literature suggests.