Nighttime Sleep Duration Is Associated With Length of Stay Outcomes Among Older Adult Survivors of Critical Illness.
Dimens Crit Care Nurs
; 39(3): 145-154, 2020.
Article
em En
| MEDLINE
| ID: mdl-32251163
ABSTRACT
BACKGROUND:
Older adults who required mechanical ventilation while in an intensive care unit (ICU) require adequate sleep throughout recovery from critical illness. Poor post-ICU sleep quality may contribute to worsening impairments in physical, cognitive, or psychological status after critical illness, known as post-ICU syndrome. Previous research has evaluated post-ICU sleep with qualitative or mixed methods (eg, interviews, questionnaires). We proposed measurement of sleep with actigraphy. We hypothesized that nighttime sleep is associated with length of stay (LOS).OBJECTIVES:
The aims of this study were to describe sleep quality of previously mechanically ventilated older adults recently transferred out of ICU and explore relationships between sleep duration and LOS outcomes.METHODS:
We enrolled 30 older adults, 65 years and older, within 24 to 48 hours after ICU discharge. We collected actigraphy data on post-ICU sleep duration (total sleep time [TST]) and sleep fragmentation (wake time after sleep onset) over 2 consecutive nights. We explored associations between TST and LOS (in days) outcomes using multivariate regression.RESULTS:
Subjects' mean TST was 7.55 ± 2.52 hours, and mean wake time after sleep onset was 2.26 ± 0.17 hours. In exploratory regression analyses, longer ICU LOS (ß = 0.543, P < .001) and longer length of mechanical ventilation (ß = 0.420, P = .028) were associated with greater post-ICU TST, after adjusting for potential confounding factors. Total sleep time was prospectively associated with total hospital LOS (ß = 0.535, P < .001).DISCUSSION:
Older ICU survivors demonstrate greater sleep duration and worse sleep fragmentation. Poor sleep may contribute to longer LOS, secondary to post-ICU syndrome and sequelae. We recommend nursing interventions to promote sleep consolidation throughout transitions of care in the acute post-ICU recovery period.
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Sono
/
Estado Terminal
/
Unidades de Terapia Intensiva
Tipo de estudo:
Qualitative_research
/
Risk_factors_studies
Limite:
Aged
/
Humans
Idioma:
En
Revista:
Dimens Crit Care Nurs
Ano de publicação:
2020
Tipo de documento:
Article