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논문KCI 등재

중환자실 환자의 수면

Sleep in Intensive Care Unit Patients

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대한수면연구학회 (Korean Sleep Research Society)|2021.08|Journal of sleep medicine|제18권 제2호|pp. 66-71|DOI 10.13078/jsm.210016

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참고문헌

키워드

SleepIntensive care unitCircadian rhythm.

초록

Sleep disturbances are common among patients admitted to the intensive care unit (ICU); however, these issues tend to receive less attention because critical care is prioritized in seriously ill patients. Recent studies have reported that sleep disturbances in patients admitted to the ICU are associated with delirium, weakened immunity, long-term cognitive decline, and persistent sleep disorders. Sleep disturbances in the ICU are attributable to the disease per se and also to the ICU environment that is not conducive to good sleep. Continuous exposure to light and noise are major environmental risk factors that disrupt the circadian rhythm and interfere with deep sleep. Sleep analysis using polysomnography in patients admitted to the ICU typically reveals increase in sleep latency, sleep fragmentation, and decreased stage N3 and rapid eye movement sleep, which are associated with poor prognosis even in patients with severe neurological conditions, including traumatic brain injury and intracranial hemorrhage. Polysomnography is the gold standard for objective evaluation of sleep; however, its applicability is limited in ICU settings, and novel methods such as continuous electroencephalographic spectral analysis and actigraphy have recently been proposed in clinical practice. Efforts to reduce nighttime light and noise (which are modifiable environmental factors) can improve sleep quality. In this article, the author reviews the studies that discuss characteristics of sleep disturbances, the associated risk factors and their correlation with prognosis among patients admitted to the ICU, as well as possible strategies to improve sleep quality in this patient population.

Abstract

Sleep disturbances are common among patients admitted to the intensive care unit (ICU); however, these issues tend to receive less attention because critical care is prioritized in seriously ill patients. Recent studies have reported that sleep disturbances in patients admitted to the ICU are associated with delirium, weakened immunity, long-term cognitive decline, and persistent sleep disorders. Sleep disturbances in the ICU are attributable to the disease per se and also to the ICU environment that is not conducive to good sleep. Continuous exposure to light and noise are major environmental risk factors that disrupt the circadian rhythm and interfere with deep sleep. Sleep analysis using polysomnography in patients admitted to the ICU typically reveals increase in sleep latency, sleep fragmentation, and decreased stage N3 and rapid eye movement sleep, which are associated with poor prognosis even in patients with severe neurological conditions, including traumatic brain injury and intracranial hemorrhage. Polysomnography is the gold standard for objective evaluation of sleep; however, its applicability is limited in ICU settings, and novel methods such as continuous electroencephalographic spectral analysis and actigraphy have recently been proposed in clinical practice. Efforts to reduce nighttime light and noise (which are modifiable environmental factors) can improve sleep quality. In this article, the author reviews the studies that discuss characteristics of sleep disturbances, the associated risk factors and their correlation with prognosis among patients admitted to the ICU, as well as possible strategies to improve sleep quality in this patient population.

참고문헌 (50)

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Factors influencing sleep quality in the intensive care unit: a descriptive pilot study in Korea안윤혜, 이상민, 이진우, Lee Hong Yeul대한중환자의학회 · Acute and Critical Care2023 · 제38권 제3호인공호흡기 적용 환자의 수면양상과 수면장애 요인김나현, 이정미병원간호사회 · 임상간호연구2011 · 제17권 제3호Reliability of the Korean version of the Richards-Campbell Sleep Questionnaire김재경, 박주희, 이상민, 이진우, 조재영대한중환자의학회 · Acute and Critical Care2020 · 제35권 제3호Association of natural light exposure and delirium according to the presence or absence of windows in the intensive care unit배은혜, 이상민, 이진우, 이홍열, 이효진대한중환자의학회 · Acute and Critical Care2021 · 제36권 제4호The effects of environmental interventions for delirium in critically ill surgical patients이학재, 정윤중, 최낙준, 홍석경대한중환자의학회 · Acute and Critical Care2023 · 제38권 제4호중환자실 환자의 수면과 관련요인에 대한 연구고진강병원간호사회 · 임상간호연구2007 · 제13권 제2호

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