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An Automated Algorithm for Determining Sleep Using Single-Channel Electroencephalography to Detect Delirium: A

Kentaro Matsui1,2,3, Nobuo Sato4, Masafumi Idei4,5

  • 1Department of Psychiatry, Tokyo Women's Medical University, Tokyo 1628666, Japan.

Healthcare (Basel, Switzerland)
|September 23, 2022
PubMed
Summary

Intensive care unit (ICU) patients with delirium experience significant sleep deprivation, with automated sleep monitoring potentially aiding detection. This study highlights marked sleep disturbances in these critically ill patients.

Keywords:
critically ill patientsdeliriumintensive care unitsingle-channel electroencephalographysleepunder-mattress sleep monitor

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Area of Science:

  • Critical Care Medicine
  • Sleep Science
  • Neuroscience

Background:

  • Polysomnography-based sleep staging in intensive care units (ICUs) is inconsistent for critically ill patients.
  • Manual sleep stage determination presents limitations in accurately assessing sleep in this population.

Purpose of the Study:

  • To objectively measure 24-hour sleep patterns in ICU patients using automated sleep monitoring devices.
  • To investigate the relationship between objective sleep metrics and the presence of delirium in critically ill patients.

Main Methods:

  • Employed a single-channel electroencephalogram (SleepScope) and an under-mattress sleep monitor (Nemuri SCAN) for automated sleep/wakefulness determination.
  • Monitored sleep in 18 ICU patients (median age, 68 years) post-cardiac surgery for 24 hours after extubation.
  • Compared sleep data between patients with and without delirium.

Main Results:

  • Significant sleep deprivation and increased daytime sleeping were observed in ICU patients with delirium.
  • Two delirious patients exhibited very short total sleep times (TST-SS: 48 and 125 min) and predominantly daytime sleep (>80%).
  • Automated sleep monitoring showed potential in identifying sleep disturbances associated with delirium.

Conclusions:

  • Automated sleep/wakefulness determination using single-channel EEG may be a valuable tool for detecting delirium in ICU patients.
  • This approach could potentially offer advantages over traditional polysomnography in this clinical setting.
  • Findings suggest marked sleep deprivation and altered sleep architecture in ICU patients with delirium.