Intensive care unit interventions to promote sleep and circadian biology in reducing incident delirium: a scoping review

Thorax, Год журнала: 2024, Номер 79(10), С. 988 - 997

Опубликована: Фев. 13, 2024

Despite plausible pathophysiological mechanisms, research is needed to confirm the relationship between sleep, circadian rhythm and delirium in patients admitted intensive care unit (ICU). The objective of this review summarise existing studies promoting, whole or part, normalisation sleep biology their impact on incidence, prevalence, duration and/or severity ICU.

Язык: Английский

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Circadian medicine: a critical strategy for cardiac care

Nature Reviews Cardiology, Год журнала: 2023, Номер 20(11), С. 715 - 716

Опубликована: Авг. 29, 2023

Язык: Английский

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Parental Perspectives From the Survey of Sleep Quality in the PICU Validation Study on Environmental Factors Causing Sleep Disruption in Critically Ill Children

Critical Care Medicine, Год журнала: 2024, Номер unknown

Опубликована: Сен. 13, 2024

Objectives: Sleep promotion bundles being tested in PICUs use elements adapted from adult bundles. As children may react differently than adults ICU environments, this study investigated what parents report disrupted the sleep of their child a PICU. Design: Secondary analysis multicenter validation Survey quality Setting: Four Northeastern U.S. PICUs, one hospital-based pediatric laboratory. Patients: Parents sleeping at bedside PICU or Interventions: Anonymous one-time survey eliciting parts hospital environments that have been described as disruptive to validated and inpatient questionnaires. Measurements Main Results: Level disruption was scored by Likert scale, with higher scores indicating more disruption. Age, demographics, baseline sleep, exposures were used describe causes Of 152 parents, 71% children’s significantly least aspect The most prevalent “being pain uncomfortable because they are sick” (38%), “not home” (30%), “alarms on machines” (28%), home schedule” (26%). Only 5% excessive nocturnal light exposure. Overall not different across four those receiving sedation. control group, healthy undergoing polysomnography, had less despite Conclusions: There multiple aspects critical care affect children, which adults, such schedules. Future interventional should include sedated could be applicable settings.

Язык: Английский

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Nonpharmacological interventions to promote sleep in the adult critical patients unit: A scoping review

Australian Critical Care, Год журнала: 2025, Номер 38(3), С. 101159 - 101159

Опубликована: Янв. 16, 2025

Sleep and circadian rhythms are markedly altered in intensive care unit (ICU) patients. Numerous factors related to the patient ICU environment affect ability initiate maintain sleep. Therefore, nonpharmacological interventions could play an essential role improving sleep rhythm. The aim of this study was examine evaluated for promoting adult ICUs. A scoping review conducted, including randomised controlled trials, nonrandomised quasi-experimental other studies investigating effects total 57 articles 14 ongoing trials were included review, which 38 clinical trials. Nine improve critically ill patients evaluated: earplugs and/or eye masks, aromatherapy, bundles, music intervention, massage or acupressure, noise masking, bright light, dynamic light. Most simultaneously assessed effect more than one intervention on perceived quality using questionnaires. association between improved varied. In case multicomponent interventions, it is difficult identify components might have influenced improvement. various promote patients, several quality. However, substantial variability their implementation complicates drawing reliable conclusions. protocol registered with Open Science Framework under identifier https://doi.org/10.17605/OSF.IO/MPEQ5.

Язык: Английский

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Are ICU Bedspaces Based in Evidence, and Do They Support Patient Sleep? A Narrative Review

HERD Health Environments Research & Design Journal, Год журнала: 2025, Номер 18(2), С. 193 - 207

Опубликована: Фев. 2, 2025

Objective: This narrative review summarizes some of the evidence guiding current intensive care unit (ICU) design, focussing on environmental factors impacting sleep, and compares available recommendations to ICU designs builds. Background: The importance sleep for recovery after illness is well known. However, hospitalized patients frequently experience poor disrupted sleep. especially true admitted ICU. There are many negatively patients' ability Some relate their or pre-existing problems; others patient activities. While bedspace may facilitate 24h care, there growing awareness detrimental impact environment (especially suboptimal lighting excessive sound/noise) has quality, important questions raised regarding how this health outcomes. Multiple guidelines exist guide design. have been whether contemporary ICUs evidence-based, effectively translated into built Methods: A comprehensive literature was conducted, exploring supporting design Results conclusion: outcomes describes features that not adhere best contribute Suggestions bedspaces can be improved optimize provided.

Язык: Английский

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Interaction between clock genes, melatonin and cardiovascular outcomes from ICU patients

Intensive Care Medicine Experimental, Год журнала: 2025, Номер 13(1)

Опубликована: Фев. 17, 2025

Abstract Background Circadian rhythms, driven by biological clocks, help organisms align their physiological functions with environmental changes, promoting homeostasis. The central clock in the suprachiasmatic nucleus coordinates peripheral clocks via neurohumoral feedback involving proteins like CLOCK, BMAL1, CRY 1/2, and PER 1–3. In ICU, these circadian processes often face disruptions from constant lighting, noise, irregular sleep–wake cycles, impairing sleep quality worsening stress responses. These can lead to adverse clinical effects, including higher cardiovascular complication rates. This study examines how ICU stays affect rhythm regulators association outcomes. Results Significant differences were identified melatonin levels expression of PER1, RORA, NR1D1 between ≤7 days >7 days. APACHE-II severity scale influenced PER2, CRY2, RORA. Nonlinear relationships observed melatonin, genes, heart rate, blood pressure (systolic diastolic). certain groups, molecular data showed correlations exceeding 90%. Conclusions findings highlight a robust disruption, as measured rhythms patients.

Язык: Английский

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Sleep in the ICU – A complex challenge requiring multifactorial solutions

Critical Care and Resuscitation, Год журнала: 2025, Номер 27(1), С. 100097 - 100097

Опубликована: Фев. 28, 2025

Язык: Английский

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Prospective cohort study on characteristics, associated factors and short-term prognosis of sleep and circadian rhythm in intensive care unit: protocol for the SYNC study

BMJ Open, Год журнала: 2025, Номер 15(3), С. e091184 - e091184

Опубликована: Март 1, 2025

Acute sleep and circadian rhythm (SCR) disruption can lead to a range of negative physical mental consequences, such as depression, delirium, respiratory dysfunction increased mortality. In the intensive care unit (ICU), unique environment exacerbate disruptions in SCR. Few studies have identified characteristics SCR ICU, roles patient characteristics, illness medical interventions ICU remain unclear. A single-centre prospective cohort study, called SYNC study (Sleep rhYthm iNtensive Care unit), will be conducted explore associated factors investigate short-term prognosis among patients surgical ICU. Patients from at tertiary teaching hospital enrolled. assessed by both objective subjective indicators, including melatonin secretion rhythm, activity pattern perceived quality. Data on eight potential that influence SCR, light exposure, noise level, pain nighttime disturbances, mechanical ventilation, sedative analgesic use, meal restraints, collected. These data gathered first 3 days after admission. Short-term prognostic anxiety, cognitive function, insomnia, activities daily living, stay, stay mortality collected during 1 month discharge. The has been approved Ethics Committee Zhongshan Hospital, Fudan University (B2024-076R). results this published peer-reviewed journals. NCT06346613.

Язык: Английский

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Factors influencing sleep disturbances in patients staying in general departments

Central European Journal of Nursing and Midwifery, Год журнала: 2025, Номер 16(1), С. 2119 - 2126

Опубликована: Март 5, 2025

Aim: The main objective was to determine how hospitalized patients subjectively perceive sleep disturbances. study also assessed the influence of selected factors (physiological, physical, environmental, and psychological) clinical demographic variables on disruption. Design: A multicenter descriptive study. Methods: Conducted in seven Czech hospitals from February May 2023, included 397 general wards. Data were collected using a modified questionnaire disturbances, results analyzed non-parametric statistical tests. Results: sample comprised 193 males (48.6 %) 204 females (51.4%). Females reported more disturbances than (p = 0.023). Psychological physical had greater impact females. Younger poorer quality 0.015). Pain strongest factor that negatively affected (Ra 0.730). Environmental leading cause disturbance 0.836). variability associated with all studied (environmental, psychological, physiological, physical) accounted for 97.6% total disturbance. Conclusion: younger experienced environmental primary causes disrupted sleep. Differences noted affecting between genders.

Язык: Английский

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Delir: verstehen, vermeiden und behandeln

neuroreha, Год журнала: 2025, Номер 17(01), С. 31 - 43

Опубликована: Март 1, 2025

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