SCCM Resource Library-Sleep: No Spindles, Apples, or Curses Required

Video Transcription

Video Summary

Sleep disruption is a common problem in the intensive care unit (ICU), and it has been linked to poor outcomes. Various factors, such as noise, light, medications, and care activities, can disrupt sleep in ICU patients. Sedation is commonly used in the ICU, but it is not the same as sleep. Sleep is a complex process that involves both the circadian rhythm and homeostatic drive for sleep. The circadian rhythm is regulated by the master clock located in the suprachiasmatic nucleus of the hypothalamus. Bright light is the primary entrainer of the circadian rhythm. Disruptions to the circadian rhythm can have negative effects on sleep. Melatonin, an endogenous hormone that regulates sleep and circadian rhythm, can also be disrupted in critically ill patients. In the ICU, sleep disruption is common, and studies have shown that ICU noise and light levels exceed recommended limits and can disrupt sleep. Medications commonly used in the ICU, such as sedatives, opioids, and vasopressors, can also disrupt sleep and impact melatonin secretion. Overall, sleep disruption in the ICU can lead to increased stress, delirium, impaired cognition, and other negative outcomes. There is limited evidence supporting the use of sleep medications, such as propofol, benzodiazepines, and dexmedetomidine, for sleep promotion in the ICU. More research is needed to better understand the effects of these medications and to develop effective strategies for improving sleep in ICU patients.

Asset Subtitle

Neuroscience, Pharmacology, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Recognize causes of, and solutions for, sleep disruption
Assess advantages and disadvantages of pharmacologic sleep aids in critically ill patients

Sleep Disrupters
Margaret A. Pisani

Melatonin: Deep ICU Sleep Support?
Laura Baumgartner

Other Sleep Aids for Critically Ill Patients
Rima Bouajram

Meta Tag

Content Type Presentation

Knowledge Area Neuroscience

Knowledge Area Pharmacology

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Sleep Medicine

Tag Analgesia and Sedation

Year 2021

Keywords

sleep disruption

intensive care unit

ICU

circadian rhythm

melatonin

medications

negative outcomes

sleep medications

improving sleep

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