Abstract
Intensive Care Unit (ICU) patients recovering from critical illness often present persistent respiratory failure and require prolonged mechanical ventilation (PMV). The aim of this study was to assess sleep quality in PMV patients, during hospitalization in ICU and in a Respiratory Intermediate Unit (RIU).
Patients and methods: A total of 39 PMV patients (13 in ICU and 26 in RIU) were included in the study. All patients were in stable condition, without need for sedation, with GCS >10. All patients were tracheostomized under mechanical ventilation support at least during the night. A full PSG was performed in all patients during night sleep under PS ventilation.
Results: Sleep efficiency was higher in ICU (82,7±18,3%, RIU 68,4±21,8%, p=0,02) with longer sleep time (SPT ICU 448±52 min, RIU 346±56 min, p<0,001). Duration of stage N2 was 61,4±20,6% in ICU and 48,8±20,5% in RIU, with longer stage N3 in RIU (10,7±15,6%, ICU 5,7±12,6%), but these differences were not statistically significant. Yet, REM sleep duration was longer in RIU (10,3±8,6%, ICU 3,7±4,9%, p=0,01). Despite pressure support ventilation during night sleep, some breathing abnormalities appeared in RIU patients, with hypoxemia especially during REM (94, 4±3, 2%, ICU 98,3±0,6%) and apneas or hypopneas (AHI 3,34±11,6/h).
Conclusions: Sleep quality was impaired in PMV patients during hospitalization either in ICU or in RIU, but sleep structure approached normal architecture in RIU. REM sleep breathing abnormalities in RIU patients may require further clinical evaluation in terms of the efficacy of mechanical ventilation mode.
- © 2011 ERS