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Best Practice for Improving Sleep in the ICU. Part I: Non-pharmacologic

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Sleep in Critical Illness

Abstract

Supporting normal sleep and circadian function is believed to be an essential component of promoting recovery in critically ill adults admitted to the 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 acute illness and critical care treatments. Each of these areas represents a potential target for non-pharmacologic intervention to promote normal sleep and circadian function. Clinicians can improve sleep opportunity by creating an environment conducive to sleep. This may include addressing acute psychosocial or physical discomfort, accommodating patients’ habitual sleep preferences, and/or reducing the presence or perception of environmental stimuli. Multi-component sleep-promotion bundles include practice changes aimed at achieving these goals via clustering patient care, reducing sound and light disturbance, and offering earplugs and/or eye masks, among other measures. Chronotherapeutic interventions may also improve sleep and circadian function by aligning human behaviors such a sleep and eating with biologic night. This chapter will review current evidence for non-pharmacologic therapies to improve sleep and circadian function in ICU patients and highlight emerging strategies that hold promise as future interventions.

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  1. Department of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA

    Amy S. Korwin & Melissa P. Knauert

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  1. Amy S. Korwin
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  2. Melissa P. Knauert
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Correspondence to Melissa P. Knauert .

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  1. Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Gerald L. Weinhouse

  2. Bouve College of Health Sciences, Northeastern University and Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    John W. Devlin

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Korwin, A.S., Knauert, M.P. (2022). Best Practice for Improving Sleep in the ICU. Part I: Non-pharmacologic. In: Weinhouse, G.L., Devlin, J.W. (eds) Sleep in Critical Illness. Springer, Cham. https://doi.org/10.1007/978-3-031-06447-0_14

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