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A Systematic Review of Risk Factors for Sleep Disruption in Critically Ill Adults
Kimia Honarmand1,2, Hammad Rafay1,2, Jamie Le3
1Division of Critical Care Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Critical Care Medicine
|May 21, 2020
Summary
Critically ill adults experience sleep disruption due to pain, anxiety, noise, and light. Factors like comorbidities and delirium also contribute to poor sleep quality in the intensive care unit (ICU).
Area of Science:
- Critical Care Medicine
- Sleep Medicine
- Systematic Review Methodology
Background:
- Sleep disruption is a prevalent issue in the intensive care unit (ICU) setting.
- Numerous factors contributing to sleep disturbances in critically ill patients have been identified.
Purpose of the Study:
- To systematically review and synthesize all described risk factors for sleep disruption in critically ill adults within the ICU.
- To categorize identified risk factors based on patient-reported reasons, ratings, and statistical associations.
Main Methods:
- A systematic review was conducted using multiple databases (PubMed, EMBASE, CINAHL, Web of Science, Cochrane).
- English-language studies from 1990-2018 involving critically ill adults and sleep disruption risk factors were included.
- Study quality was assessed using the Newcastle-Ottawa Scale or Cochrane Risk of Bias tool.
Main Results:
- 62 studies were included, identifying pain, discomfort, anxiety, noise, and light as common patient-reported sleep disruptors.
- Patients identified noise and light as the most disruptive factors.
- Comorbidities, poor home sleep quality, home sleep aid use, and delirium were associated with sleep disruption.
Conclusions:
- This review consolidates premorbid, illness-related, and ICU-related factors impacting sleep in critically ill patients.
- Findings provide a foundation for sleep promotion strategies and future research in ICUs.
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