A Systematic Review of Risk Factors for Sleep Disruption in Critically Ill Adults. Issue 7 (July 2020)

• Record Type: Journal Article
• Authors: Honarmand, Kimia; Rafay, Hammad; Le, Jamie; Mohan, Sindu; Rochwerg, Bram; Devlin, John W.; Skrobik, Yoanna; Weinhouse, Gerald L.; Drouot, Xavier; Watson, Paula L.; McKinley, Sharon; Bosma, Karen J.
• Is Part Of: Critical care medicine. Volume 48:Issue 7(2020)
• Publication Date: 2020-07
• Subjects: intensive care -- risk factor -- sleep -- systematic review; Critical care medicine -- Periodicals; Soins intensifs -- Périodiques; 616.028
• DOI: 10.1097/CCM.0000000000004405
• Languages: English
• ISSNs: 0090-3493

Abstract

Abstract : Objectives: Numerous risk factors for sleep disruption in critically ill adults have been described. We performed a systematic review of all risk factors associated with sleep disruption in the ICU setting. Data Sources: PubMed, EMBASE, CINAHL, Web of Science, Cochrane Central Register for Controlled Trials, and Cochrane Database of Systematic Reviews. Study Selection: English-language studies of any design published between 1990 and April 2018 that evaluated sleep in greater than or equal to 10 critically ill adults (> 18 yr old) and investigated greater than or equal to 1 potential risk factor for sleep disruption during ICU stay. We assessed study quality using Newcastle-Ottawa Scale or Cochrane Risk of Bias tool. Data Extraction: We abstracted all data independently and in duplicate. Potential ICU sleep disruption risk factors were categorized into three categories based on how data were reported: 1) patient-reported reasons for sleep disruption, 2) patient-reported ratings of potential factors affecting sleep quality, and 3) studies reporting a statistical or temporal association between potential risk factors and disrupted sleep. Data Synthesis: Of 5, 148 citations, we included 62 studies. Pain, discomfort, anxiety/fear, noise, light, and ICU care-related activities are the most common and widely studied patient-reported factors causing sleep disruption. Patients rated noise and light as the most sleep-disruptive factors. Higher number of comorbidities, poor home sleep quality, home sleep aid use, and delirium were factors associated with sleep disruption identified in available studies. Conclusions: This systematic review summarizes all premorbid, illness-related, and ICU-related factors associated with sleep disruption in the ICU. These findings will inform sleep promotion efforts in the ICU and guide further research in this field. Abstract : Supplemental Digital Content is available in the text.