Sleep Quality and Delirium Occurrence in Intensive Care Unit Patients: A Prospective Observational Study

Area of Science:

• Critical care medicine
• Sleep science
• Neuroscience

Background:

• Intensive care unit (ICU) patients frequently experience sleep disturbances.
• Circadian rhythm disruption from poor sleep is a known risk factor for delirium.
• Empirical research on the sleep-delirium association in ICUs is limited.

Purpose of the Study:

• To investigate the association between sleep quality and delirium development in ICU patients.
• To identify specific sleep parameters that may predict delirium onset.

Main Methods:

• Prospective observational study in six ICUs across three university hospitals.
• Sleep parameters measured using the Fitbit Sense wearable device.
• Delirium assessed using the Confusion Assessment Method for the ICU (CAM-ICU).
• Multivariable logistic regression analysis employed.

Main Results:

• Shorter sleep time and higher wake after sleep onset (WASO) on the first night were significantly associated with delirium on the second day.
• Delirium on the third day was linked to greater disease severity and prior delirium.
• No significant association found between first-night sleep parameters and third-day delirium.

Conclusions:

• Reduced sleep time and increased WASO during the first night in the ICU may contribute to delirium development.
• Critical care nurses should monitor patient sleep and implement early interventions for circadian rhythm support.
• These interventions are crucial for delirium prevention strategies in the ICU.