Sleep Deprivation In The ICU

During patient rounding on the intensive care units (ICU), one of the consistent concerns I hear from patients and families is how difficult it is to sleep in the ICU. Sleep deprivation and fragmentation impairs neurocognitive function and healing (Friese, 2008), (Drouot, Cabello, D’Ortho & Brochard, 2008). The incidence of delirium in the ICU varies from 20% to 80% depending upon the severity of patient illness and the assessment method used (Girard, Pandharipande & Ely, 2008). Delirium often goes unrecognized by ICU providers or is incorrectly attributed as an expected complication of critical illness or dementia (Girard et al., 2008). Delirium is associated with poor short-term outcomes and may result in adverse sequelae years after ICU

Formal polysomnography (PSG) is the standard measurement for assessing sleep. The size of the PSG machine, the number of electrodes, wires and sensors that are needed in addition to the need for a PSG technician to interpret the results, makes formal PSG impractical for critical care. Due to the challenges of measuring sleep in the ICU it is not routinely done. Since sleep is rarely measured in the ICU, it is difficult to determine the effect of sleep deprivation and disruption on delirium. The relative influence of environment, illness and interventions on sleep in critically ill patients is essentially unknown (Friese, 2008) (Drouot et al., 2008). The more we began to explore sleep the more we came to realize the complexity of this seemingly simple project. We quickly realized that if we want to show improved sleep by decreased noise, we need a way to objectively measure sleep. If we want to show decreased incidence of delirium by improved sleep we need to consistently and accurately measure delirium and if we want to promote sleep we need create a silent

We believe this project will show causative effect and correlation between sleep disruption and delirium. This project will have the potential to impact all three of the primary goals for our organization: Patient satisfaction, quality and financial strength. The exciting part of this project is that each phase has the potential to impact and improve patient care independent of the other phases. The primary goal for this project is to make a difference in the lives of our patients through innovation and improved