<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2021-0023_s_008">
<h3>Background and objective</h3>
<p>The sleep architecture of critically ill patients being treated in Intensive Care Units (ICU) and High Dependency Units (HDU) is frequently unsettled and inadequate both qualitatively and quantitatively. The study aimed to investigate and elucidate factors influencing sleep architecture and quality in ICU and HDU in a limited resource setting with financial constraints, lacking human resources and technology for routine monitoring of noise, light and sleep promotion strategies in ICU.</p>
</sec>
<sec id="j_jccm-2021-0023_s_009">
<h3>Methods</h3>
<p>The study was longitudinal, prospective, hospital-based, analytic, and observational. Insomnia Severity Index (ISI) and the Epworth Sleepiness Scale (ESS) pre hospitalisation scores were recorded. Patients underwent 24-hour polysomnography (PSG) with the simultaneous monitoring of noise and light in their environments. Patients stabilised in ICU were transferred to HDU, where the 24-hour PSG with the simultaneous monitoring of noise and light in their environments was repeated. Following PSG, the Richards-Campbell Sleep Questionnaire (RCSQ) was employed to rate patients’ sleep in both the ICU and HDU.</p>
</sec>
<sec id="j_jccm-2021-0023_s_010">
<h3>Results</h3>
<p>Of 46 screened patients, 26 patients were treated in the ICU and then transferred to the HDU. The mean (SD) of the study population’s mean (SD) age was 35.96 (11.6) years with a predominantly male population (53.2% (n=14)). The mean (SD) of the ISI and ESS scores were 6.88 (2.58) and 4.92 (1.99), respectively. The comparative analysis of PSG data recording from the ICU and HDU showed a statistically significant reduction in N1, N2 and an increase in N3 stages of sleep (p&lt;0.05). Mean (SD) of RCSQ in the ICU and the HDU were 54.65 (7.70) and 60.19 (10.85) (p-value = 0.04) respectively. The disease severity (APACHE II) has a weak correlation with the arousal index but failed to reach statistical significance (coeff= 0.347, p= 0.083).</p>
</sec>
<sec id="j_jccm-2021-0023_s_011">
<h3>Conclusion</h3>
<p>Sleep in ICU is disturbed and persisting during the recovery period in critically ill. However, during recovery, sleep architecture shows signs of restoration.</p>
</sec>

</abstract>

Background and objective
The sleep architecture of critically ill patients being treated in Intensive Care Units (ICU) and High Dependency Units (HDU) is frequently unsettled and inadequate both qualitatively and quantitatively. The study aimed to investigate and elucidate factors influencing sleep architecture and quality in ICU and HDU in a limited resource setting with financial constraints, lacking human resources and technology for routine monitoring of noise, light and sleep promotion strategies in ICU.


Methods
The study was longitudinal, prospective, hospital-based, analytic, and observational. Insomnia Severity Index (ISI) and the Epworth Sleepiness Scale (ESS) pre hospitalisation scores were recorded. Patients underwent 24-hour polysomnography (PSG) with the simultaneous monitoring of noise and light in their environments. Patients stabilised in ICU were transferred to HDU, where the 24-hour PSG with the simultaneous monitoring of noise and light in their environments was repeated. Following PSG, the Richards-Campbell Sleep Questionnaire (RCSQ) was employed to rate patients’ sleep in both the ICU and HDU.


Results
Of 46 screened patients, 26 patients were treated in the ICU and then transferred to the HDU. The mean (SD) of the study population’s mean (SD) age was 35.96 (11.6) years with a predominantly male population (53.2% (n=14)). The mean (SD) of the ISI and ESS scores were 6.88 (2.58) and 4.92 (1.99), respectively. The comparative analysis of PSG data recording from the ICU and HDU showed a statistically significant reduction in N1, N2 and an increase in N3 stages of sleep (p<0.05). Mean (SD) of RCSQ in the ICU and the HDU were 54.65 (7.70) and 60.19 (10.85) (p-value = 0.04) respectively. The disease severity (APACHE II) has a weak correlation with the arousal index but failed to reach statistical significance (coeff= 0.347, p= 0.083).


Conclusion
Sleep in ICU is disturbed and persisting during the recovery period in critically ill. However, during recovery, sleep architecture shows signs of restoration.

Evaluation of Sleep Architecture Using 24-hour Polysomnography in Patients Recovering from Critical Illness in an Intensive Care Unit and High Dependency Unit: A Longitudinal, Prospective, and Observational Study

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background and objective
The sleep architecture of critically ill patients being treated in Intensive Care Units (ICU) and High Dependency Units (HDU) is...

Evaluation of Sleep Architecture Using 24-hour Polysomnography in Patients Recovering from Critical Illness in an Intensive Care Unit and High Dependency Unit: A Longitudinal, Prospective, and Observational Study

Article Category: Research article

Published Online: Nov 06, 2021

Page range: 257 - 266

Received: Mar 09, 2021

Accepted: Jun 28, 2021

DOI: https://doi.org/10.2478/jccm-2021-0023

Keywords
sleep deprivation, sleep stages, polysomnography, sleep disorders

© 2021 Brijesh Prajapat, Nitesh Gupta, Dhruva Chaudhry, Ario Santini, AS Sandhya, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Evaluation of Sleep Architecture Using 24-hour Polysomnography in Patients Recovering from Critical Illness in an Intensive Care Unit and High Dependency Unit: A Longitudinal, Prospective, and Observational Study

Article Category: Research article

Published Online: Nov 06, 2021

Page range: 257 - 266

Received: Mar 09, 2021

Accepted: Jun 28, 2021

DOI: https://doi.org/10.2478/jccm-2021-0023

Keywordssleep deprivation, sleep stages, polysomnography, sleep disorders

© 2021 Brijesh Prajapat, Nitesh Gupta, Dhruva Chaudhry, Ario Santini, AS Sandhya, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
sleep deprivation, sleep stages, polysomnography, sleep disorders