INTRODUCTION: It has been repeatedly shown that sleep of intensive care unit (ICU) patients is fragmented and its architecture is impaired. As sleep disorders have numerous negative effects on the organism, there have been efforts to implement sleep-promoting strategies into practice. When comparing the effectiveness of such measures, sleep quality assessment itself is a considerable problem. OBJECTIVE: The study aimed to assess the quality and quantity of night sleep in ICU patients simultaneously with actigraphy (ACT) and the Richards-Campbell Sleep Questionnaire (RCSQ). The secondary goals were to test the performance and effectiveness of the above methods and to verify correlations between selected RCSQ items and actigraph parameters. METHODS: A single-center prospective observational study (20 patients staying in a Interdisciplinary Intensive Care Unit). The quality of sleep was assessed using a Czech version of the RCSQ and ACT. The obtained data were analyzed and their dependence or correlations were verified by selected statistical tests. RESULTS: The mean RCSQ score was 47.6 (SD 24.4). The worst results were found for sleep latency (44.4; SD 31.2); the best results were for sleep quality (50.2; SD 29.4). The mean sleep effciency measured with ACT reached 86.6% (SD 9.2); the mean number of awakenings per night was 17.1 (SD 8.5). The RCSQ total parameter with a cutoff of 50 (RCSQ total = 50 good sleep / RCSQ total < 50 poor sleep) was shown to be suitable for discrimination of subjectively perceived sleep quality in ICU patients. However, the study failed to show statistically significant relations between subjectively perceived sleep quality (RCSQ) and ACT measurements. CONCLUSION: The RCSQ appears to be a suitable instrument for assessing night sleep quality in ICU patients. On the other hand, the study showed a very low level of agreement between subjective sleep quality assessment and objective ACT measurements. The main drawback of ACT is low reliability of obtained data. Further research is needed to determine its role in sleep quality assessment in the ICU setting.

• Klíčová slova
• Actigraphy, Intensive Care Unit, Richards-Campbell Sleep Questionnaire, Sleep,
• Publikační typ
• časopisecké články MeSH

Intensive care unit (ICU) environment has a very strong and unavoidable negative impact on patients' sleep. Sleep deprivation in ICU patients has been already studied and negative effects on their outcome (prolonged ICU stay, decreased recovery) and complication rates (incidence of delirium, neuropsychological sequels of critical illness) discussed. Several interventions potentially improving the sleep disturbance in ICU (sleep-promotion strategies) have been assumed and tested for clinical practice. We present a review of recent literature focused on chosen types of non-pharmacological interventions (earplugs and eye mask) analysing their effect on sleep quality/quantity. From the total amount of 82 papers found in biomedical databases (CINAHL, PubMed and SCOPUS) we included the 19 most eligible studies meeting defined inclusion/exclusion criteria involving 1 379 participants. Both experimental and clinical trials, either ICU and non-ICU patient populations were analysed in the review. Most of the reviewed studies showed a significant improvement of subjective sleep quality when using described non-pharmacological interventions (objective parameters were not significantly validated). Measuring the sleep quality is a major concern limiting the objective comparison of the studies' results since non-standardised (and mainly individual) tools for sleep quality assessment were used. Despite the heterogeneity of analysed studies and some common methodological issues (sample size, design, outcome parameters choice and comparison) earplugs and eye mask showed potential positive effects on sleep quality and the incidence of delirium in ICU patients.

• Klíčová slova
• earplugs, eye mask, hospitalisation, intensive care unit, quality of sleep,
• MeSH
• chrániče sluchu * trendy   MeSH
• delirium epidemiologie   patofyziologie   terapie   MeSH
• jednotky intenzivní péče * trendy   MeSH
• lidé MeSH
• ochranné prostředky očí * trendy   MeSH
• péče o pacienty v kritickém stavu metody   trendy   MeSH
• poruchy spánku a bdění epidemiologie   patofyziologie   prevence a kontrola   MeSH
• randomizované kontrolované studie jako téma metody   MeSH
• spánek fyziologie   MeSH
• spánková deprivace epidemiologie   patofyziologie   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

AIM: To examine the effects of mechanical ventilation on the quality of sleep in patients in the intensive care unit (ICU) using recent and relevant literature. METHODS: To verify the examined objective, the results of the analysis of available original scientific works have been used including defined inclusion/exclusion criteria and search strategy. Appropriate works found were analysed further. The applied methodology was in line with the general principles of Evidence-Based Medicine. The following literary databases were used: CINAHL, Medline and gray literature: Google Scholar. RESULTS: A total of 91 trials were found. Eleven of these relevant to the follow-up analysis were selected: all trials were carried out under real ICU conditions and the total of 192 patients were included in the review. There is an agreement within all trials that sleep in patients requiring mechanical ventilation is disturbed. Most reviewed trials have shown that mechanical ventilation is probably not the main factor causing sleep disturbances, but an appropriate ventilation strategy can significantly help to improve its quality by reducing the frequency of the patient-ventilator asynchrony. CONCLUSION: Based on the analysis, it appears that an appropriate ventilation mode setting can have a beneficial effect on the quality of sleep in ICU patients.

• Klíčová slova
• intensive care unit, mechanical ventilation, quality of sleep,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH