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

描述（由申请人提供）：经过数十年描述危重患者睡眠质量差的研究，临床研究开始关注重症监护室（ICU）相关睡眠障碍对患者结局的影响。这种兴趣源于新出现的数据，这些数据表明ICU相关的睡眠剥夺和中断有助于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。然而，很少有睡眠相关的干预措施已被评估，以改善ICU患者的结果。本项目的目的是评估睡眠改善干预措施对单个医学ICU患者结局的影响。拟议的研究是一个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睡眠障碍的最小化。ICU中的睡眠促进将在6个月的时间内分三个渐进阶段进行：第1阶段）环境干预（最大限度地减少开销页面/警报，调暗灯光，关闭患者的门）;第2阶段）非药物个性化干预（耳塞，眼罩，舒缓音乐），以及第3阶段）建立关于使用适当的睡眠促进药物的指南。这些阶段性睡眠改善干预措施的有效性将通过每天收集Richards-Campbell睡眠问卷来评估，该问卷是针对每名MICU患者在ICU住院期间的感知睡眠质量，合格的ICU幸存者将在ICU出院后完成经验证的“ICU睡眠”问卷和一系列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，可广泛用于ICU环境，以改善睡眠和患者的预后。 公共卫生相关性：我们正在努力帮助重症监护室的病人睡得更好。在我们的研究中，我们将消除重症监护室的噪音和明亮的灯光，并给予药物帮助患者睡眠。我们将询问患者的睡眠情况，看看更好的睡眠是否有助于思考或康复。

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.