Top

Intensive Care Medicine

Published in:

01-02-2009 | Original

Chronic sleep disorders in survivors of the acute respiratory distress syndrome

Authors: Christie M. Lee, Margaret S. Herridge, Jonathan Y. Gabor, Catherine M. Tansey, Andrea Matte, Patrick J. Hanly

Published in: Intensive Care Medicine | Issue 2/2009

Abstract

Purpose

Sleep disruption is well recognized in the Intensive Care Unit. Poor sleep quality likely continues following discharge from hospital in several patients and becomes a chronic disorder in some. The aim of this study was to describe the etiology of chronic sleep complaints in survivors of ARDS.

Methods

Seven ARDS survivors with no previous sleep complaints who reported difficulty sleeping 6 months or more following discharge from hospital were evaluated. Sleep quality was assessed subjectively with a sleep history and the Insomnia Severity Index and objectively with polysomnography. Daytime sleepiness was assessed with the Epworth Sleepiness Scale.

Results

A chronic sleep disorder was identified in each patient who reported difficulty sleeping. The primary sleep disorder was chronic conditioned insomnia (5 patients), parasomnia (1 patient) and obstructive sleep apnea (1 patient). In addition, 4 patients had periodic leg movements, which was of uncertain clinical significance.

Conclusion

Chronic sleep disorders, which originate during the acute illness, are present in some ARDS survivors several months after discharge from hospital. If unrecognized, lack of treatment may contribute to impaired quality of life and incomplete rehabilitation from their critical illness.

Available only for authorised users

Aurell J, Elmqvist D (1985) Sleep in the surgical intensive care unit: continuous polygraphic recording of sleep in nine patients receiving postoperative care. Br Med J (Clin Res Ed) 290:1029–1032

Broughton R, Baron R (1978) Sleep patterns in the intensive care unit and on the ward after acute myocardial infarction. Electroencephalogr Clin Neurophysiol 45:348–360PubMedCrossRef

Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ (2000) Sleep in critically ill patients requiring mechanical ventilation. Chest 117:809–818PubMedCrossRef

Freedman NS, Gazendam J, Levan L, Pack AI, Schwab RJ (2001) Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med 163:451–457PubMed

Freedman NS, Kotzer N, Schwab RJ (1999) Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit. Am J Respir Crit Care Med 159:1155–1162PubMed

Gabor JY, Cooper AB, Crombach SA, Lee B, Kadikar N, Bettger HE, Hanly PJ (2003) Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects. Am J Respir Crit Care Med 167:708–715PubMedCrossRef

Hanly PJ (2006) Sleep in the ventilated patient. In: Tobin M (edn) Principles and practice of mechanical ventilation, 2nd edn. McGraw Hill, pp 1173–1184

Bosma K, Ferreyra G, Ambrogio C, Pasero D, Mirabella L, Braghiroli A, Appendini L, Mascia L, Ranieri VM (2007) Patient–ventilator interaction and sleep in mechanically ventilated patients: pressure support versus proportional assist ventilation. Crit Care Med 35:1048–1054PubMedCrossRef

Cameron JI, Herridge MS, Tansey CM, McAndrews MP, Cheung AM (2006) Well-being in informal caregivers of survivors of acute respiratory distress syndrome. Crit Care Med 34:81–86PubMedCrossRef

10.

Hopkins RO, Weaver LK, Collingridge D, Parkinson RB, Chan KJ, Orme JF Jr (2005) Two-year cognitive, emotional, and quality-of-life outcomes in acute respiratory distress syndrome. Am J Respir Crit Care Med 171:340–347PubMedCrossRef

11.

Dowdy DW, Eid MP, Sedrakyan A, Mendez-Tellez PA, Pronovost PJ, Herridge MS, Needham DM (2005) Quality of life in adult survivors of critical illness: a systematic review of the literature. Intensive Care Med 31:611–620PubMedCrossRef

12.

Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, az-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S, Stewart TE, Barr A, Cook D, Slutsky AS (2003) One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 348:683–693PubMedCrossRef

13.

Bastien CH, Vallieres A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2:297–307PubMedCrossRef

14.

Johns MW (1993) Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest 103:30–36PubMedCrossRef

15.

Littner M, Hirshkowitz M, Kramer M, Kapen S, Anderson WM, Bailey D, Berry RB, Davila D, Johnson S, Kushida C, Loube DI, Wise M, Woodson BT (2003) Practice parameters for using polysomnography to evaluate insomnia: an update. Sleep 26:754–760PubMed

16.

Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545PubMed

17.

American Academy of Sleep Medicine (2005) Insomnia. In: Sateia MJ (ed) The international classification of sleep disorders: diagnostic & coding manual, 2nd edn. American Academy of Sleep Medicine, Westchester, pp 1–31

18.

Jansson-Fröjmark M, Linton SJ (2008) The course of insomnia over one year: a longitudinal study in the general population in Sweden. Sleep 1:881–886

19.

Simini B (1999) Patients’ perceptions of intensive care. Lancet 354:571–572PubMedCrossRef

20.

Bradley C, Nicholson A, Viveash J (1991) Opioids and non-opioids. In: Klepper I, Saunders L, Rosen M (eds) Ambulatory anesthesia and sedation: impairment and recovery. Blackwell Scientific Publications, Oxford, pp 218–234

21.

Gaillard JM, Blois R (1983) Effect of the benzodiazepine antagonist Ro 15-1788 on flunitrazepam-induced sleep changes. Br J Clin Pharmacol 15:529–536PubMed

22.

Baker CF (1984) Sensory overload and noise in the ICU: sources of environmental stress. CCQ 6:66–80PubMed

23.

Meyer TJ, Eveloff SE, Bauer MS, Schwartz WA, Hill NS, Millman RP (1994) Adverse environmental conditions in the respiratory and medical ICU settings. Chest 105:1211–1216PubMedCrossRef

24.

Murphy F, Bentley S, Ellis BW, Dudley H (1977) Sleep deprivation in patients undergoing operation: a factor in the stress of surgery. Br Med J 2:1521–1522PubMedCrossRef

25.

Topf M, Davis JE (1993) Critical care unit noise and rapid eye movement (REM) sleep. Heart Lung 22:252–258PubMed

26.

Mahowald MW, Schenck CH (1996) NREM sleep parasomnias. Neurol Clin 14:675–696PubMedCrossRef

27.

Chishti A, Batchelor AM, Bullock RE, Fulton B, Gascoigne AD, Baudouin SV (2000) Sleep-related breathing disorders following discharge from intensive care. Intensive Care Med 26:426–433PubMedCrossRef

28.

Baudouin SV, Evans T (1998) Nutrition in the Critically ill. In: Hall J, Schmidt G, Wood L (eds) Principles of Critical Care. McGraw-Hill, New York, pp 205–220

29.

Bolton CF (1996) Neuromuscular conditions in the intensive care unit. Intensive Care Med 22:841–843PubMedCrossRef

30.

Murray P (1998) Critical care pharmacology. In: Hall J, Schmidt G, Wood L (eds) Principles of critical care. McGraw-Hill, New York, pp 1527–1551

31.

Jin K, Okabe S, Chida K, Abe N, Kimpara T, Ohnuma A, Nomura H, Itoyama Y, Onodera H (2007) Tracheostomy can fatally exacerbate sleep-disordered breathing in multiple system atrophy. Neurology 68:1618–1621PubMedCrossRef

32.

Sanna A, Fargnoli R, Camiciottoli G (2006) Obstructive sleep apnea syndrome as a complication after tracheal surgery. J Clin Sleep Med 2:458–459PubMed

33.

Ohayon MM, Roth T (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53:547–554PubMedCrossRef

34.

Garcia-Borreguero D, Egatz R, Winkelmann J, Berger K (2006) Epidemiology of restless legs syndrome: the current status. Sleep Med Rev 10:153–167PubMedCrossRef

35.

Gemignani F, Brindani F, Negrotti A, Vitetta F, Alfieri S, Marbini A (2006) Restless legs syndrome and polyneuropathy. Mov Disord 21:1254–1257PubMedCrossRef

36.

Nineb A, Rosso C, Dumurgier J, Nordine T, Lefaucheur JP, Creange A (2007) Restless legs syndrome is frequently overlooked in patients being evaluated for polyneuropathies. Eur J Neurol 14:788–792PubMedCrossRef

37.

Artigas A, Bernard GR, Carlet J, Dreyfuss D, Gattinoni L, Hudson L, Lamy M, Marini JJ, Matthay MA, Pinsky MR, Spragg R, Suter PM (1998) The American-European Consensus Conference on ARDS, part 2: ventilatory, pharmacologic, supportive therapy, study design strategies, and issues related to recovery and remodeling. Acute respiratory distress syndrome. Am J Respir Crit Care Med 157:1332–1347PubMed

38.

Harvey AG, Jones C, Schmidt DA (2003) Sleep and posttraumatic stress disorder: a review. Clin Psychol Rev 23:377–407PubMedCrossRef

39.

Griffiths J, Fortune G, Barber V, Young JD (2007) The prevalence of post traumatic stress disorder in survivors of ICU treatment: a systematic review. Intensive Care Med 33:1506–1518PubMedCrossRef

40.

Chesson A Jr, Hartse K, Anderson WM, Davila D, Johnson S, Littner M, Wise M, Rafecas J (2000) Practice parameters for the evaluation of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 23:237–241PubMed

Title: Chronic sleep disorders in survivors of the acute respiratory distress syndrome
Authors: Christie M. Lee
Margaret S. Herridge
Jonathan Y. Gabor
Catherine M. Tansey
Andrea Matte
Patrick J. Hanly
Publication date: 01-02-2009
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 2/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1277-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Chronic sleep disorders in survivors of the acute respiratory distress syndrome

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2009

Year in review in Intensive Care Medicine, 2008: II. Experimental, acute respiratory failure and ARDS, mechanical ventilation and endotracheal intubation

Bile acids cause secretory phospholipase A2 activity enhancement, revertible by exogenous surfactant administration

Reply to Wiedermann

Soluble intercellular adhesion molecule-1 and clinical outcomes in patients with acute lung injury

Effect of SOD-1 over-expression on myocardial function during resuscitated murine septic shock

Interactions between respiration and systemic hemodynamics. Part II: practical implications in critical care