Titlebook: Sleep in Critical Illness; Physiology, Assessme Gerald L. Weinhouse,John W. Devlin Book 2022 The Editor(s) (if applicable) and The Author(s

SMART

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Sleep Disruption and its Relationship to ICU Outcomes, itself. Abnormalities in sleep architecture and duration are associated with neurocognitive impairments and adverse patient outcomes. Sleep deprivation is also known to impair glucose metabolism and immune function, which could contribute to ICU morbidity. Circadian rhythm disturbances frequently a

CRAMP

Long-Term Outcomes: Sleep in Survivors of Critical Illness,t their wellbeing and quality of life. Sleep disturbances frequently occur during and after an ICU admission and affect these important components of ICU survivorship. Insomnia, sleep fragmentation and circadian abnormalities worsen ICU physical, cognitive, and psychological recovery. Recovery from

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Methods for Routine Sleep Assessment and Monitoring,ure sleep. Polysomnography (PSG) is considered a “gold standard” for sleep measurement but is costly, cumbersome, and vulnerable to misinterpretation in critically ill patients. Other methods such as bispectral Index (BIS) and actigraphy represent objective and more feasible alternatives to PSG but

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Best Practice for Improving Sleep in the ICU. Part I: Non-pharmacologic, intensive care unit (ICU). However, most ICU patients experience insufficient and poor-quality sleep and abnormal circadian rhythms. Many factors contribute to sleep and circadian disruption during critical illness. These include patient characteristics, environmental exposures, and effects of acut

GAVEL

Best Practices for Improving Sleep in the ICU: Part II: Pharmacologic, be considered. Dexmedetomidine, melatonin agonists (melatonin and ramelteon), and gabaminergic agents (i.e., propofol and benzodiazepines) are the most commonly-studied medications to improve sleep in critically ill adults. While some of these agents, when used for sleep, have reduced delirium, non

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Sleep Considerations in Critically Ill Children,hood. However, PICU care and its environment often disrupts circadian rhythm (CR) and sleep, which are imperative for healing and healthy growth and development in this vulnerable pediatric population. To optimize sleep in critically ill children, it is vital to understand the heterogeneity of the P

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Induction

Characteristics of Sleep in Critically Ill Patients: Part II: Circadian Rhythm Disruption,ich “dysrhythm” are adaptive and which are harmful and thus represent targets for intervention. In this chapter, we review the basis of circadian rhythms, the circadian disrupters found in ICUs, and the changes in circadian rhythms in critically ill patients.

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