Table 1.
Studies examining sleep in the intensive care unit that have included individuals 80 years and older
| Study | Sample age range | Sleep measures | Major findings |
|---|---|---|---|
| Whitcomb et al99 | 68–83 | Wireless sleep monitor | Sedation and lack of REM sleep increased symptoms of delirium |
| Roche-Campo et al100 | 25–86 | PSG | Sleep quality higher during mechanical ventilation |
| Chang et al101 | 65–86 | Recorded interviews (narratives) | Continuous sleep disrupted due to constant noise (eg, equipment, staff) |
| Chen et al102 | 53–90 | PSG; actigraphy; nurse observations; Stanford Sleepiness Scale | Valerian, acupressure increased sleep time, decreased wake frequency, decreased sleepiness |
| Drouot et al58 | 58–85 | PSG | Decreased REM sleep, slow EEG activity, impaired EEG reactivity during wakefulness |
| Savi et al103 | 35–80 | Nottingham Health Profile self-report questionnaire | Inspiratory muscle strength improved sleep quality |
| Zeilani and Seymour104 | 19–82 | Recorded interviews (narratives) | Pain was a contributing factor to sleep disturbance |
| Roche Campo et al105 | 72–85 | PSG | Noninvasive ventilation failure results in poorer sleep quality, less REM sleep, and greater circadian disruption |
| Kelly and McKinley106 | 19–84 | SF-36 | Interrupted sleep while in the ICU may be due to frequent interventions, uncomfortable beds or noise from machinery, conversations or other patients; survivors perceived good health despite disturbed sleep during recovery |
| Beecroft et al107 | 55–80 | PSG; actigraphy; nurse assessment | Decreased total sleep time and sleep efficiency, high frequency of awakenings; elevated stage 1 and decreased REM sleep; highly fragmented sleep |
| Bourne et al108 | 46–82 | Bispectral index; actigraphy; nurse assessment; patient self-report (Richards Campbell Sleep Questionnaire) | Melatonin increased nocturnal sleep by 1 hour |
| Cabello et al109 | 47–85 | PSG | Mechanical ventilation was associated with short REM sleep and increased sleep architecture fragmentation |
| Friese et al110 | 20–83 | PSG | Average total sleep time was 8.23 hours; 6.2 hours of awakenings; reduced stages 3 and 4, and REM |
| Hweidi111 | 35–80 | Intensive Care Environmental Stressor Scale | Not being able to sleep was perceived as a primary stressor |
| Toublanc et al112 | 42–81 | PSG | Assist-control ventilation was associated with increased stages 1 and 2, and reduced wakefulness during first half of night; increased stages 3 and 4 during the second half of night |
| Hellgren and Ståhle113 | 35–85 | SF-36 | No change |
| Olofsson et al80 | 52–83 | Melatonin secretion; nurse assessment (Sedation-Agitation Scale); bispectral index | Circadian rhythm of melatonin was abolished during deep sedation and mechanical ventilation |
| Tamburri et al114 | 48–84 | Nurse activity checklist | High frequency of nocturnal care leaves few opportunities for uninterrupted sleep |
| Frisk et al77 | 41–88 | Melatonin secretion | Mechanical ventilation was association with decreased melatonin secretion |
| Frisk and Nordström76 | 19–85 | Nurse and patient questionnaire (Richards Campbell Sleep Questionnaire); patient interview | Hypnotics/sedatives results in poorer sleep scores; No difference between nurse and patient reports |
| Freedman et al65 | 20–83 | PSG | Environmental noise is partly responsible for qualitative reports of sleep disruption |
| Freedman et al63 | 19–86 | Self-report questionnaire | Poor sleep quality and daytime sleepiness is commonly reported in ICU settings |
Abbreviations: EEG, electroencephalogram; ICU, intensive care unit; PSG, polysomnography; REM, rapid eye movement; SF-36, self-report 36-item short-form health survey.