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Sleep disturbance in older ICU patients

Authors Sterniczuk R, Rusak B, Rockwood K

Received 31 December 2013

Accepted for publication 24 February 2014

Published 23 June 2014 Volume 2014:9 Pages 969—977

DOI https://doi.org/10.2147/CIA.S59927

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Roxanne Sterniczuk,1–3 Benjamin Rusak,1,2 Kenneth Rockwood3

1Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, 2Department of Psychiatry, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, NS, 3Division of Geriatric Medicine, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada

Abstract: Maintaining a stable and adequate sleeping pattern is associated with good health and disease prevention. As a restorative process, sleep is important for supporting immune function and aiding the body in healing and recovery. Aging is associated with characteristic changes to sleep quantity and quality, which make it more difficult to adjust sleep–wake rhythms to changing environmental conditions. Sleep disturbance and abnormal sleep–wake cycles are commonly reported in seriously ill older patients in the intensive care unit (ICU). A combination of intrinsic and extrinsic factors appears to contribute to these disruptions. Little is known regarding the effect that sleep disturbance has on health status in the oldest of old (80+), a group, who with diminishing physiological reserve and increasing prevalence of frailty, is at a greater risk of adverse health outcomes, such as cognitive decline and mortality. Here we review how sleep is altered in the ICU, with particular attention to older patients, especially those aged ≥80 years. Further work is required to understand what impact sleep disturbance has on frailty levels and poor outcomes in older critically ill patients.

Keywords: intensive care unit, sleep–wake rhythm, aging, frailty

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