Feasibility of Measuring Sleep in a Critical Care Environment

在重症监护环境中测量睡眠的可行性

• 批准号: 7924067
• 负责人: MARGARET A PISANI
• 金额: $ 20.51万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7924067
• 关键词: Address; Adult; Adverse effects; Age; Anxiety; Arousal; Awareness; Behavioral; Biological Process; Caregivers; Caring; Characteristics; Chronic; Circadian Rhythms; Comorbidity; Critical Care; Critical Illness; Cues; Data; Delirium; Development; Discipline of Nursing; Electroencephalography; Enrollment; Environment; Family Nursing; Generations; Goals; Gold; Grant; Hour; Immune; Impairment; Intensive Care Units; Interruption; Intervention; Knowledge; Lead; Measures; Mechanical ventilation; Medical; Metabolic; Methods; Motion; Nature; Noise; Outcome; Outpatients; Pain; Participant; Patient observation; Patients; Pattern; Pharmaceutical Preparations; Physiological; Pilot Projects; Polysomnography; Precipitating Factors; Predisposing Factor; REM Sleep; Reporting; Research; Research Design; Respiratory Failure; Risk Factors; Severities; Sleep; Sleep Architecture; Sleep Deprivation; Sleep Disorders; Sleep Fragmentations; Sleep Stages; Sleep disturbances; System; Testing; Time; Ventilator; Work; actigraphy; base; cognitive function; cost effective; data acquisition; glucose metabolism; hypnotic; immune function; improved; indexing; intervention effect; non rapid eye movement; older patient; patient population; public health relevance; sedative; sensor; Address; Adult; Adverse effects; Age; Anxiety; Arousal; Awareness; Behavioral; Biological Process; Caregivers; Caring; Characteristics; Chronic; Circadian Rhythms; Comorbidity; Critical Care; Critical Illness; Cues; Data; Delirium; Development; Discipline of Nursing; Electroencephalography; Enrollment; Environment; Family Nursing; Generations; Goals; Gold; Grant; Hour; Immune; Impairment; Intensive Care Units; Interruption; Intervention; Knowledge; Lead; Measures; Mechanical ventilation; Medical; Metabolic; Methods; Motion; Nature; Noise; Outcome; Outpatients; Pain; Participant; Patient observation; Patients; Pattern; Pharmaceutical Preparations; Physiological; Pilot Projects; Polysomnography; Precipitating Factors; Predisposing Factor; REM Sleep; Reporting; Research; Research Design; Respiratory Failure; Risk Factors; Severities; Sleep; Sleep Architecture; Sleep Deprivation; Sleep Disorders; Sleep Fragmentations; Sleep Stages; Sleep disturbances; System; Testing; Time; Ventilator; Work; actigraphy; base; cognitive function; cost effective; data acquisition; glucose metabolism; hypnotic; immune function; improved; indexing; intervention effect; non rapid eye movement; older patient; patient population; public health relevance; sedative; sensor

DESCRIPTION (provided by applicant): Sleep is an essential biological function that has physiological, behavioral and temporal characteristics. It is regulated by homeostatic and circadian processes. The knowledge of the importance of sleep and the adverse effects of sleep deprivation has grown in an exponential manner over the last few years. Although approximately 5.7 million adults are cared for in an intensive care unit (ICU) annually in the U.S, and despite the growing awareness of the potential importance of sleep in the ICU, many questions about the nature of sleep, the predictors and consequences of sleep disruption and the efficacy of sleep promoting interventions in critically ill patients remain unanswered. This grant proposes the following Specific Aims: Specific Aim 1: Determine feasibility of acquiring high quality portable polysomnographic (PSG) data over a 24-hour period among patients age 60 and older in the medical intensive care unit (MICU) who have respiratory failure requiring mechanical ventilation. Feasibility will consist of three components: 1. Patient, family and nursing acceptance of PSG in critically ill patients. 2. Ability to perform a 24-hour portable PSG in mechanically ventilated patients in the MICU. 3. Ability to obtain EEG data to examine sleep latency, sleep stages, and sleep duration. Specific Aim 2: Describe the severity of sleep disruption over a 24-hour period among patients age 60 and older admitted with respiratory failure who are mechanically ventilated. For the purpose of hypothesis generation we will track both predisposing and precipitating factors which may contribute to sleep disruption. Specific Aim 3: Describe sleep architecture and the distribution of sleep over a 24-hour period among patients age 60 and older admitted with respiratory failure who are mechanically ventilated. Sleep disruption has been shown to have important effects on immune function, glucose metabolism and cognitive function, all of which may contribute to poor outcomes from critical illness. More importantly sleep is a potentially modifiable factor in the intensive care unit. Once accurate sleep data is collected we can begin to examine how sleep disruption, shifts in sleep stages, and alterations in circadian rhythms impact critical care outcomes including delirium. The information obtained in this pilot study will also be useful for designing studies that examine predisposing and precipitating risk factors for sleep disruption in critical illness and the effect of using sedative-hypnotic medications on sleep patterns. PUBLIC HEALTH RELEVANCE: There are 5.7 million adults admitted to intensive care units (ICU) each year in the U.S. Little is known about the impact of sleep in the ICU. The goal of the study is to examine the feasibility of using portable polysomnography to study sleep in older patients admitted to a medical ICU who require mechanical ventilation. The ultimate goal of this research is to better understand factors which lead to impaired sleep in critical illness, the importance of sleep on outcomes from ICU care and to develop interventions to promote sleep in a critical care environment.

描述（由申请人提供）：睡眠是具有生理，行为和时间特征的重要生物学功能。它受体内平衡和昼夜节律的监管。在过去的几年中，人们对睡眠重要性和睡眠剥夺的不利影响的了解已经以指数式增长。尽管每年在美国的重症监护室（ICU）中受到约570万成年人的照顾，尽管人们对ICU睡眠的潜在重要性的潜在意识越来越认识，但许多关于睡眠性质的问题，睡眠中断的预测因素和后果，睡眠中断的预测和后果以及促进批判性病患者的睡眠疗效的疗效。该赠款提出了以下特定目的：具体目标1：确定在60岁及60岁以上的患者中，在需要机械频繁的呼吸衰竭的60岁及以上的患者中，在60岁及60岁以上的患者中获得高质量的便携式多聚会（PSG）数据的可行性。可行性将由三个组成部分组成：1。危重患者的患者，家庭和护理接受率。 2。在MICU中的机械通风患者中执行24小时便携式PSG的能力。 3.能够获取脑电图数据以检查睡眠潜伏期，睡眠阶段和睡眠持续时间的能力。具体目标2：描述60岁及60岁及以上的患者的睡眠严重性在机械通风的患者中被释放出呼吸衰竭。出于假设产生的目的，我们将跟踪可能导致睡眠破坏的诱发和降水因素。特定目标3：描述60岁及60岁及以上的患者的睡眠结构和睡眠分布在机械通风的60岁及以上的患者中。睡眠中断已显示出对免疫功能，葡萄糖代谢和认知功能的重要影响，所有这些都可能导致危害疾病的不良结果。更重要的是，睡眠是重症监护病房的潜在可修改因素。一旦收集了准确的睡眠数据，我们就可以开始研究睡眠破坏，睡眠阶段的转移以及昼夜节律的改变会影响包括del妄的重症监护效果。在这项试验研究中获得的信息也将用于设计研究研究的研究和促进危害危险中的危险因素，以及使用镇静性催眠药对睡眠模式的影响。公共卫生相关性：在美国，每年有570万成年人接受重症监护病房（ICU），这对ICU的睡眠影响知之甚少。该研究的目的是检查使用便携式多聚疗法研究需要机械通气的医疗ICU的老年患者的睡眠的可行性。这项研究的最终目的是更好地理解导致严重疾病睡眠受损的因素，睡眠对ICU护理结果的重要性以及在重症监护环境中促进睡眠的干预措施。