Table 1.
Demographics and clinical characteristics of 112 ICU survivors grouped by subjective sleep disturbances at the initial CCRC visit
| Characteristics | No sleep disturbances (N=53) | Sleep disturbances (N=59) | P-value |
|---|---|---|---|
| Demographics | |||
| Age (years) | 56.8 (10.9) | 48.0 (14.1) | 0.001 |
| Female, % | 45.3 (24) | 54.2 (32) | 0.449 |
| African-American, % | 43.4 (23) | 42.4 (25) | 1.000 |
| Education (years) | 11.9 (2.4) | 11.6 (3.2) | 0.513 |
| Comorbidities | |||
| Alcohol use disorder (current or previous), % | 39.6 (19) | 24.1 (14) | 0.097 |
| Tobacco use disorder (current or previous), % | 81.1 (43) | 71.2 (42) | 0.271 |
| CNS disorder, % | 45.3 (24) | 57.6 (34) | 0.256 |
| Cardiac disease, % | 41.5 (22) | 28.8 (17) | 0.171 |
| Hypertension, % | 77.4 (41) | 59.3 (35) | 0.046 |
| Diabetes, % | 30.2 (16) | 32.2 (19) | 0.841 |
| COPD, % | 58.5 (31) | 42.4 (25) | 0.130 |
| Cancer, % | 15.1 (8) | 17.0 (10) | 1.000 |
| Psychiatric disorder, % | 11.3 (6) | 15.2 (9) | 0.590 |
| Sleep disorder, % | 7.6 (4) | 6.8 (4) | 1.000 |
| Hospital characteristicsb | |||
| Length of hospitalization (days) | 17.0 (11.3) | 21.3 (23.3) | 0.987 |
| Length of ICU (days) | 12.2 (9.8) | 13.1 (18.3) | 0.271 |
| Delirium during entire hospitalization, % | 84.9 (45) | 71.2 (42) | 0.112 |
| Respiratory failure, % | 96.2 (51) | 74.6 (44) | 0.001 |
| Initial CCRC visit information | |||
| Time between initial visit in CCRC and discharge from the hospital (days) | 116.8 (87.2) | 93.8 (62.3) | 0.186 |
| MMSE (0–30 points) | 26.2 (4.2) | 25.5 (4.7) | 0.588 |
| Antidepressant prescription at initial CCRC visit, % | 24.5 (13) | 42.4 (25) | 0.071 |
| Benzodiazepine or nonbenzodiazepine hypnotic prescription at initial CCRC visit, % | 13.2 (7) | 5.1 (3) | 0.187 |
| Global trauma-related and depression symptoms | 0.009 | ||
| Trauma-related and depression symptoms | 5.7 (3) | 39.0 (23) | |
| Trauma-related symptoms, no depression symptoms | 15.1 (8) | 25.4 (15) | |
| Depression symptoms, no trauma-related symptoms | 13.2 (7) | 10.2 (6) | |
| No trauma-related or depression symptoms, history of depressionb | 26.4 (14) | 10.2 (6) | |
| No trauma-related or depression symptoms, no history of depression | 39.6 (21) | 15.2 (9) | |
Notes: Continuous variables were expressed as average (SD). Categorical variables were expressed as % (N). P-values are from comparisons between those with no changes in sleep and changes in sleep groups. Patients who were on any dose of a tricyclic antidepressant, serotonin reuptake inhibitor, serotonin–norepinephrine reuptake inhibitor, noradrenergic and specific serotonergic antidepressant (eg, mirtazapine), or norepinephrine and dopaminergic reuptake inhibitor (eg, bupropion) were considered to be on an antidepressant. Nonbenzodiazepine hypnotics were defined as drugs with effects similar to benzodiazepines, eg, zolpidem, zopiclone, eszopiclone, and zaleplon. Depression symptoms were defined as patients who indicated moderate to severe depressive symptoms (Geriatric Depression Scale-30 ≥20 or Patient Health Questionnaire-9 ≥10) at the initial CCRC visit prior to treatment in the CCRC. Trauma-related symptoms were defined as patients who endorsed having at least one of the following: nightmares, flashback or stressful memory of ICU stay, jumpiness (easily frightened or startled by sudden movements), or fear or place of situations that remind people of their ICU stay.
Hospital stay with sentinel ICU stay resulting in CCRC referral.
History of depression was defined as a diagnosis of depression based on informant report or chart diagnosis of depression. Fisher’s exact tests were used to compare categorical outcomes for the two groups. Wilcoxon Rank-Sum tests were used to compare continuous outcomes for the two groups. Psychiatric and sleep disorders were defined as any relevant ICD-9 or ICD-10 diagnoses by chart review within the 365 days prior to ICU admission.
Abbreviations: CCRC, Critical Care Recovery Center; CNS, central nervous disease; ICU, intensive care unit; MMSE, Mini-Mental State Examination.