Sleep in the Intensive Care Unit and Role of Mechanical Ventilation

Abstract

Sleep is deeply altered in mechanically ventilated ICU patients. The mechanisms responsible for altered sleep include the presence of an endotracheal tube, patient-ventilator asynchronies, caregiving activities, environmental noise and light, and severity of illness.

Since sleep deprivation is a risk factor for neurologic and physical complications, improving sleep in ICU is deemed to be a relevant issue. Yet, it has been demonstrated that ventilatory mode and settings impact sleep in intubated and tracheotomized patients. Moreover, noninvasive ventilation not only improves sleep, but poor sleep under noninvasive ventilation may predict bad outcomes.

To date environmental and pharmacological strategies have failed to promote sleep in the ICU, but future directions focus on multifaceted quality improvement strategies that may eventually increase sleep quality in ICU patients.