An ICU Sleep Intervention to Improve Perceived Sleep Quality & Cognitive Function

描述（由申请人提供）：经过几十年对重症患者睡眠质量差的研究，临床调查开始关注重症监护病房（ICU）相关睡眠障碍对患者预后的影响。新出现的数据表明，重症监护病房相关的睡眠剥夺和中断会导致心血管和免疫功能障碍、代谢紊乱、谵妄、其他神经心理障碍和恢复时间延长，这引起了人们的兴趣。然而，很少有与睡眠相关的干预措施被评估为改善ICU患者的预后。本项目的目的是评估睡眠改善干预措施对单个医学ICU患者预后的影响。本研究是一项MICU范围内的多阶段睡眠改善项目，涉及多方面的睡眠促进干预和减少睡眠障碍。在6个月的时间里，促进ICU的睡眠将分三个渐进阶段进行：阶段1)环境干预（尽量减少头顶的页面/警报器，调暗灯光，关闭病人的门）；阶段2)非药物个体化干预（耳塞、眼罩、舒缓音乐），阶段3)建立适当的睡眠促进药物使用指南。这些阶段性睡眠改善干预措施的有效性将通过每天收集每个MICU患者在ICU住院期间感知睡眠质量的Richards-Campbell睡眠问卷来评估，符合条件的ICU幸存者将在ICU出院后完成一份经过验证的“ICU睡眠”问卷和一组简短的神经认知测试。该项目的最终目标是评估简单可行的干预措施，这些干预措施可广泛用于ICU环境，以改善睡眠和患者预后。

DESCRIPTION (provided by applicant): After decades of research describing the poor sleep quality of critically ill patients, clinical investigations are beginning to focus on the effects of intensive care unit (ICU)-associated sleep disturbances on patient outcomes. This interest has arisen from emerging data suggesting that ICU-related sleep deprivation and disruption contributes to cardiovascular and immune dysfunction, metabolic derangements, delirium, other neuropsychological disturbances, and prolonged recovery. However, few sleep-related interventions have been evaluated to improve ICU patients' outcomes. The purpose of this project is to evaluate the effect of sleep improvement interventions on patient outcomes in a single medical ICU. The proposed study is a MICU- wide, multi-stage sleep improvement project involving multi-faceted sleep promoting interventions and minimization of sleep disturbances. Promotion of sleep in the ICU will occur in three incremental stages over a 6-month period: Stage 1) environmental interventions (minimization of overhead pages/alarms, dimming of lights, closing patients' doors); Stage 2) non-pharmacologic individualized interventions (earplugs, eye masks, soothing music), and Stage 3) establishing a guideline regarding use of appropriate sleep promoting medications. Effectiveness of these staged sleep improvement interventions will be evaluated by daily collection of the Richards-Campbell Sleep Questionnaire of perceived sleep quality for every MICU patient during their ICU stay, and eligible ICU survivors will complete a validated "Sleep in the ICU" questionnaire and a short battery of neurocognitive tests after ICU discharge. The ultimate goal of this project is to evaluate simple and feasible interventions that can be widely used in the ICU setting to improve sleep and patient outcomes. PUBLIC HEALTH RELEVANCE: We are trying to help patients in the Intensive Care Unit sleep better. In our research study, we will get rid of loud noises and bright lights in the Intensive Care Unit, and give medicine to help patients sleep. We will ask patients about their sleep and see if better sleep helps with thinking or healing.