危重症患者和危重症幸存者的睡眠结构模式:一项回顾性研究。

IF 6.8 2区 医学 Q1 RESPIRATORY SYSTEM
Dimitris Georgopoulos, Eumorfia Kondili, Beth Gerardy, Christina Alexopoulou, Maria Bolaki, Magdy Younes
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引用次数: 2

摘要

理由:在重症监护室(ICU)期间和之后,危重患者的睡眠异常非常常见。人们对它们的机制知之甚少。比值比乘积(ORP)是以3秒为间隔测量的睡眠深度的连续度量(范围0.0-2.5),并从不同脑电图频率的功率彼此之间的关系中导出。当用覆盖整个ORP范围的10个ORP十分位数内的时期的百分比表示时,它提供了关于异常睡眠机制的信息。目的:确定先前接受过睡眠研究的危重患者和危重症幸存者的ORP结构类型。方法:对47例未确诊的危重症患者和23例出院危重症幸存者的夜间多导睡眠图进行分析。当天还监测了12名危重患者,15名幸存者随后接受了多导睡眠图检查。6 出院后数月。在所有多导睡眠图中,每个30秒的时期都以10个3秒时期的平均ORP为特征。计算平均ORP在覆盖整个ORP范围(0.0-2.5)的10个ORP十分位数内的30秒时期的数量,并将其表示为总记录时间的百分比。此后,使用两位数的ORP类型对每个多导睡眠图进行表征,第一位数(范围1-3)反映了深度睡眠(ORP)的增加程度  2.25,十分位数10)。将患者的结果与831名年龄和性别匹配的无睡眠障碍社区居民的结果进行比较。结果:在危重患者中,1,1和1,2型(很少深度睡眠和很少或平均完全清醒)占主导地位(46%的患者)。在社区中,这些类型的睡眠异常并不常见(结论:危重症患者和危重症幸存者的睡眠异常主要是由阻碍进入深度睡眠的刺激或过度兴奋状态的存在引起的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sleep Architecture Patterns in Critically Ill Patients and Survivors of Critical Illness: A Retrospective Study.

Rationale: Sleep abnormalities are very frequent in critically ill patients during and after intensive care unit (ICU) stays. Their mechanisms are poorly understood. The odds ratio product (ORP) is a continuous metric (range, 0.0-2.5) of sleep depth measured in 3-second intervals and derived from the relationship of powers of different electroencephalographic frequencies to one another. When expressed as the percentage of epochs within 10 ORP deciles covering the entire ORP range, it provides information about the mechanism(s) of abnormal sleep. Objectives: To determine ORP architecture types in critically ill patients and survivors of critical illness who had previously undergone sleep studies. Methods: Nocturnal polysomnograms from 47 unsedated critically ill patients and 23 survivors of critical illness at hospital discharge were analyzed. Twelve critically ill patients were monitored also during the day, and 15 survivors underwent subsequent polysomnography 6 months after hospital discharge. In all polysomnograms, each 30-second epoch was characterized by the mean ORP of the 10 3-second epochs. The number of 30-second epochs with mean ORP within each of 10 ORP deciles covering the entire ORP range (0.0-2.5) was calculated and expressed as a percentage of total recording time. Thereafter, each polysomnogram was characterized using a two-digit ORP type, with the first digit (range, 1-3) reflecting increasing degrees of deep sleep (ORP < 0.5, deciles 1 and 2) and the second digit (range, 1-3) reflecting increasing degrees of full wakefulness (ORP > 2.25, decile 10). Results from patients were compared with those from 831 age- and gender-matched community dwellers free of sleep disorders. Results: In critically ill patients, types 1,1 and 1,2 (little deep sleep and little or average full wakefulness) dominated (46% of patients). In the community, these types are uncommon (<15%) and seen primarily in disorders that preclude progression to deep sleep (e.g., very severe obstructive sleep apnea). Next in frequency (22%) was type 1,3, consistent with hyperarousal. Day ORP sleep architecture was similar to night results. Survivors had similar patterns, with little improvement after 6 months. Conclusions: Sleep abnormalities in critically ill patients and survivors of critical illness result primarily from stimuli that preclude progression to deep sleep or from the presence of a hyperarousal state.

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来源期刊
Annals of the American Thoracic Society
Annals of the American Thoracic Society Medicine-Pulmonary and Respiratory Medicine
CiteScore
9.30
自引率
3.60%
发文量
0
期刊介绍: The Annals of the American Thoracic Society (AnnalsATS) is the official international online journal of the American Thoracic Society. Formerly known as PATS, it provides comprehensive and authoritative coverage of a wide range of topics in adult and pediatric pulmonary medicine, respiratory sleep medicine, and adult medical critical care. As a leading journal in its field, AnnalsATS offers up-to-date and reliable information that is directly applicable to clinical practice. It serves as a valuable resource for clinical specialists, supporting their formative and continuing education. Additionally, the journal is committed to promoting public health by publishing research and articles that contribute to the advancement of knowledge in these fields.
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