Main description:

For decades heavily sedated ICU patients were assumed to be asleep. However, in the past 20 years, physiologic and epidemiologic studies have established sleep is frequently disrupted in the ICU. The inter-relationship between ICU sleep, delirium, and survivorship has come to the forefront of ICU practice. We now routinely aim for lighter sedation, delirium assessment has become standardized, and knowledge regarding the ICU factors leading to Post- Intensive Care Syndrome (PICS) has evolved. The importance of sleep in routine ICU management was codified for the first time in SCCM's 2018 PADIS guidelines.

This state of the art book summarizes current knowledge regarding sleep during critical illness and recovery and how the risk factors, recognition, and outcomes associated with sleep in the ICU differ from those of healthy adults. Chapters address sleep quality in both the research environment and during routine care, the factors that disrupt sleep architecture and circadian biology in the ICU setting, medications that alter sleep architecture and those that can be used to improve it, the relationship between sleep and sedation and between sleep and delirium, and current strategies that can be used to improve sleep in the vulnerable ICU population. Written by experts in the field, Sleep in Critical Illness is a valuable resource for all members of the ICU interprofessional team including critical care physicians, nurses, physician assistants, pharmacists, and respiratory therapists as well as clinicians who consult in the ICU and post-ICU settings.

Contents:

Introduction

Characterization of normal sleep
Characteristics of sleep in critically ill patients. Part I: Sleep fragmentation and sleep stage disruption
Characteristics of sleep in critically ill patients. Part II: Circadian rhythm disruption
Unique neurophysiologic findings in the critically ill: "atypical sleep and pathologic wakefulness"
Biologic effects of disrupted sleep
Risk factors for disrupted sleep in the ICU
Effects of common ICU medications on sleep
ICU sleep disruption and its relationship with delirium
ICU sleep disruption and its relationship with ICU outcomes
Long-term outcomes-sleep in survivors of critical illness
Recommended method (s) for routine ICU sleep assessment and monitoring
Best practice for improving sleep in the ICU. Part I: Non-pharmacologic
Best practices for improving sleep in the ICU: Part II: Pharmacologic
Special considerations in critically ill children
Future directions