重症监护室重症患者的睡眠质量和昼夜节律紊乱

Christina Athanasia Sampani, Georgios Koukoulitsios, Athanasia Liveri, Dimitrios Papageorgiou
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引用次数: 0

摘要

目的:本研究旨在评估重症监护室(ICU)重症患者的睡眠质量。方法和材料:本研究调查了雅典G. Gennimatas综合医院重症监护室在2021年1月至2023年12月期间收治的135名患者的夜间睡眠情况。使用理查兹-坎贝尔睡眠问卷(RCSQ)收集数据。为改善患者睡眠,夜间减少了感官刺激,包括噪音、光线、护理活动和侵入性程序。减少光线的措施包括在护理工作中使用特殊照明,以及在护理过程中使用床头灯。减少噪音的策略包括关闭房门、尽量减少监护仪报警以及不鼓励员工在病人床边讲话。此外,还提倡将病人护理活动分组,以减少睡眠干扰。结果:与对照组相比,干预组患者的睡眠质量有所改善,总体 RCSQ 得分显著提高(p<0.05)。性别和年龄对睡眠质量没有明显影响。不过,各组的住院时间有所不同,对照组的住院时间更短。住院时间与睡眠质量之间呈负相关,住院时间越长,RCSQ评分越低。此外,延长机械通气时间也与睡眠质量较差有关:结论:重症监护病房的患者通常表现出异常的警觉性、较差的白天睡眠质量、紊乱的夜间睡眠以及缺乏慢波睡眠和快速眼动(REM)睡眠的睡眠模式。深入了解昼夜节律在危重病管理中的作用可为未来的时间治疗策略铺平道路,从而提高临床疗效并促进患者康复:重症监护病房 睡眠质量 昼夜节律
本文章由计算机程序翻译,如有差异,请以英文原文为准。
SLEEP QUALITY AND CIRCADIAN RHYTHM DISRUPTION IN CRITICALLY ILL PATIENTS IN INTENSIVE CARE UNIT
Aim:The aim of this study was to evaluate the quality of sleep in critically ill patients in the Intensive Care Unit (ICU). Method and Material:This study investigated the night-time sleep of 135 patients admitted to the general ICU of the General Hospital of Athens G. Gennimatas between January 2021 and December 2023. Data were collected using the Richards Campbell Sleep Questionnaire (RCSQ). Sensory stimuli, including noise, light, nursing activities, and invasive procedures, were reduced during the night to improve patients sleep. Measures to reduce light included implementing special lighting during nursing tasks and using bedside lamps during care. Noise reduction strategies involved closing doors, minimizing monitor alarms, and discouraging staff from speaking near patient beds. Grouping patient care activities was also promoted to limit sleep disturbances. Results:Patients in the intervention group showed improved sleep quality compared to the control group, with a significant overall RCSQ score (p<0.05). Gender and age did not significantly affect sleep quality. However, hospital stay duration differed between groups, with the control group experiencing shorter stays. A negative correlation was observed between the duration of hospitalization and sleep quality, with longer stays linked to lower RCSQ scores. Additionally, extended mechanical ventilation was associated with poorer sleep quality. Conclusion: Patients in the ICU often exhibit abnormal levels of alertness, poor quality of daytime sleep, disrupted nighttime sleep, and sleep patterns that lack both slow-wave and rapid eye movement (REM) sleep. Gaining a deeper understanding of the role circadian rhythms play in managing critical illness could pave the way for future chronotherapeutic strategies, enhancing clinical outcomes and promoting recovery for patients. Keywords: Intensive care unit, sleep quality, circadian rhythm
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