Skip to main content

Sleep and Sleep Deprivation Among Families in the ICU

  • Chapter
  • First Online:
Families in the Intensive Care Unit

Abstract

Sleep is a biological necessity, and adequate sleep is important for neurocognitive health and wellbeing. Family members of intensive care patients may lack adequate sleep either due to the ICU environment (lack of opportunities for sleep) or due to stress and anxiety (i.e., insomnia). Moreover, difficulty sleeping may persist after ICU discharge. In addition to reviewing the key literature, we propose a model for family education and engagement to optimize sleep for family members and patients in the ICU. This model may aid in family member engagement with clinicians and may ultimately alleviate symptoms of difficulty sleeping and post-intensive care syndrome in caregivers after the ICU.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ayas NT, White DP, Manson JE, Stampfer MJ, Speizer FE, Malhotra A, et al. A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med. 2003;163(2):205–9.

    Article  PubMed  Google Scholar 

  2. Patel SR, Malhotra A, Gao X, Hu FB, Neuman MI, Fawzi WW. A prospective study of sleep duration and pneumonia risk in women. Sleep. 2012;35(1):97–101.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol. 2006;164(10):947–54.

    Article  PubMed  Google Scholar 

  4. Spiegel K, Sheridan JF, Van Cauter E. Effect of sleep deprivation on response to immunization. JAMA. 2002;288(12):1471–2.

    Article  PubMed  Google Scholar 

  5. Prather AA, Hall M, Fury JM, Ross DC, Muldoon MF, Cohen S, et al. Sleep and antibody response to hepatitis B vaccination. Sleep. 2012;35(8):1063–9.

    PubMed  PubMed Central  Google Scholar 

  6. Owens RL, Gold KA, Gozal D, Peppard PE, Jun JC, Lippman SM, et al. Sleep and breathing … acd Cancer? Cancer Prev Res (Phila). 2016;9(11):821–7.

    Article  CAS  PubMed  Google Scholar 

  7. Mukherjee S, Patel SR, Kales SN, Ayas NT, Strohl KP, Gozal D, et al. An official American Thoracic Society statement: the importance of healthy sleep. Recommendations and future priorities. Am J Respir Crit Care Med. 2015;191(12):1450–8.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of sleep medicine and Sleep Research Society. Sleep. 2015;38(6):843–4.

    PubMed  PubMed Central  Google Scholar 

  9. Weinhouse GL. Pharmacology I: effects on sleep of commonly used ICU medications. Crit Care Clin. 2008;24(3):477–91. vi

    Article  CAS  PubMed  Google Scholar 

  10. Ding Q, Redeker NS, Pisani MA, Yaggi HK, Knauert MP. Factors influencing Patients’ sleep in the intensive care unit: perceptions of patients and clinical staff. Am J Crit Care. 2017;26(4):278–86.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Tainter CR, Levine AR, Quraishi SA, Butterly AD, Stahl DL, Eikermann M, et al. Noise levels in surgical ICUs are consistently above recommended standards. Crit Care Med. 2016;44(1):147–52.

    Article  PubMed  Google Scholar 

  12. Knauert M, Jeon S, Murphy TE, Yaggi HK, Pisani MA, Redeker NS. Comparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales. J Crit Care. 2016;36:1–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Barr J, Fraser GL, Puntillo K, Ely EW, Gelinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41(1):263–306.

    Article  PubMed  Google Scholar 

  14. Kamdar BB, King LM, Collop NA, Sakamuri S, Colantuoni E, Neufeld KJ, et al. The effect of a quality improvement intervention on perceived sleep quality and cognition in a medical ICU. Crit Care Med. 2013;41:800.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Stanchina ML, Abu-Hijleh M, Chaudhry BK, Carlisle CC, Millman RP. The influence of white noise on sleep in subjects exposed to ICU noise. Sleep Med. 2005;6(5):423–8.

    Article  PubMed  Google Scholar 

  16. Jaiswal SJ, Garcia S, Owens RL. Sound and light levels are similarly disruptive in ICU and non-ICU wards. J Hosp Med. 2017;12(10):798–804.

    Article  PubMed  Google Scholar 

  17. Huang HW, Zheng BL, Jiang L, Lin ZT, Zhang GB, Shen L, et al. Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation? Crit Care. 2015;19:124.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hu RF, Jiang XY, Hegadoren KM, Zhang YH. Effects of earplugs and eye masks combined with relaxing music on sleep, melatonin and cortisol levels in ICU patients: a randomized controlled trial. Crit Care. 2015;19:115.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Fan EP, Abbott SM, Reid KJ, Zee PC, Maas MB. Abnormal environmental light exposure in the intensive care environment. J Crit Care. 2017;40:11–4.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Verceles AC, Liu X, Terrin ML, Scharf SM, Shanholtz C, Harris A, et al. Ambient light levels and critical care outcomes. J Crit Care. 2013;28(1):110 e1–8.

    Article  Google Scholar 

  21. Day A, Haj-Bakri S, Lubchansky S, Mehta S. Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: a questionnaire study. Crit Care (London, England). 2013;17(3):R91.

    Article  Google Scholar 

  22. Clark ME, Cummings BM, Kuhlthau K, Frassica N, Noviski N. Impact of pediatric intensive care unit admission on family financial status and productivity: a pilot study. J Intensive Care Med. 2017;885066617723278. [Epub ahead of print]

    Google Scholar 

  23. Halm MA, Titler MG, Kleiber C, Johnson SK, Montgomery LA, Craft MJ, et al. Behavioral responses of family members during critical illness. Clin Nurs Res. 1993;2(4):414–37.

    Article  CAS  PubMed  Google Scholar 

  24. Choi J, Tate JA, Donahoe MP, Ren D, Hoffman LA, Chasens ER. Sleep in family caregivers of ICU survivors for two months post-ICU discharge. Intensive Crit Care Nurs. 2016;37:11–8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Celik S, Genc G, Kinetli Y, Asiliogli M, Sari M, Madenoglu Kivanc M. Sleep problems, anxiety, depression and fatigue on family members of adult intensive care unit patients. Int J Nurs Pract. 2016;22(5):512–22.

    Article  PubMed  Google Scholar 

  26. Verceles AC, Corwin DS, Afshar M, Friedman EB, McCurdy MT, Shanholtz C, et al. Half of the family members of critically ill patients experience excessive daytime sleepiness. Intensive Care Med. 2014;40(8):1124–31.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Choi J, Hoffman LA, Schulz R, Ren D, Donahoe MP, Given B, et al. Health risk behaviors in family caregivers during patients’ stay in intensive care units: a pilot analysis. Am J Crit Care. 2013;22(1):41–5.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Burr G. The family and critical care nursing: a brief review of the literature. Aust Crit Care. 1997;10(4):124–7.

    Article  CAS  PubMed  Google Scholar 

  29. Elliott D, Davidson JE, Harvey MA, Bemis-Dougherty A, Hopkins RO, Iwashyna TJ, et al. Exploring the scope of post-intensive care syndrome therapy and care: engagement of non-critical care providers and survivors in a second stakeholders meeting. Crit Care Med. 2014;42(12):2518–26.

    Article  PubMed  Google Scholar 

  30. Roland P, Russell J, Richards KC, Sullivan SC. Visitation in critical care: processes and outcomes of a performance improvement initiative. J Nurs Care Qual. 2001;15(2):18–26.

    Article  CAS  PubMed  Google Scholar 

  31. Schnell D, Abadie S, Toullic P, Chaize M, Souppart V, Poncet MC, et al. Open visitation policies in the ICU: experience from relatives and clinicians. Intensive Care Med. 2013;39(10):1873–4.

    Article  PubMed  Google Scholar 

  32. Whitcomb JJ, Roy D, Blackman VS. Evidence-based practice in a military intensive care unit family visitation. Nurs Res. 2010;59(1 Suppl):S32–9.

    Article  PubMed  Google Scholar 

  33. Garrouste-Orgeas M, Philippart F, Timsit JF, Diaw F, Willems V, Tabah A, et al. Perceptions of a 24-hour visiting policy in the intensive care unit. Crit Care Med. 2008;36(1):30–5.

    Article  PubMed  Google Scholar 

  34. Davidson JE, Aslakson RA, Long AC, Puntillo KA, Kross EK, Hart J, et al. Guidelines for family-centered Care in the Neonatal, pediatric, and adult ICU. Crit Care Med. 2017;45(1):103–28.

    Article  PubMed  Google Scholar 

  35. Davidson JE, Savidan KA, Barker N, Ekno M, Warmuth D, Degen-De Cort A. Using evidence to overcome obstacles to family presence. Crit Care Nurs Q. 2014;37(4):407–21.

    Article  PubMed  Google Scholar 

  36. Kress JP, Pohlman AS, O’Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000;342(20):1471–7.

    Article  CAS  PubMed  Google Scholar 

  37. Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874–82.

    Article  PubMed  Google Scholar 

  38. Owens RL. Better sleep in the intensive care unit: blue pill or red pill... Or no pill? Anesthesiology. 2016;125(5):835–7.

    Article  PubMed  Google Scholar 

  39. Van Dongen HP, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep. 2003;26(2):117–26.

    Article  PubMed  Google Scholar 

  40. Venkatraman V, Chuah YM, Huettel SA, Chee MW. Sleep deprivation elevates expectation of gains and attenuates response to losses following risky decisions. Sleep. 2007;30(5):603–9.

    Article  PubMed  Google Scholar 

  41. Anderson C, Dickinson DL. Bargaining and trust: the effects of 36-h total sleep deprivation on socially interactive decisions. J Sleep Res. 2010;19(1 Pt 1):54–63.

    Article  PubMed  Google Scholar 

  42. Huff NG, Nadig N, Ford DW, Cox CE. Therapeutic alliance between the caregivers of critical illness survivors and intensive care unit clinicians. Ann Am Thorac Soc. 2015;12(11):1646–53.

    PubMed  PubMed Central  Google Scholar 

  43. Hunziker S, McHugh W, Sarnoff-Lee B, Cannistraro S, Ngo L, Marcantonio E, et al. Predictors and correlates of dissatisfaction with intensive care. Crit Care Med. 2012;40(5):1554–61.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Jones CB, Dorrian J, Jay SM, Lamond N, Ferguson S, Dawson D. Self-awareness of impairment and the decision to drive after an extended period of wakefulness. Chronobiol Int. 2006;23(6):1253–63.

    Article  PubMed  Google Scholar 

  45. Shaffer KM, Riklin E, Jacobs JM, Rosand J, Vranceanu AM. Mindfulness and coping are inversely related to psychiatric symptoms in patients and informal caregivers in the neuroscience ICU: implications for clinical care. Crit Care Med. 2016;44(11):2028–36.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Schmidt M, Azoulay E. Sleepless nights in the ICU: the awaken family. Crit Care. 2013;17(5):1003.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Huynh TDJ, Owens RL. Overnight ICU family presence in a model of family-centered care. Soc Crit Care Med. 2018:2018.

    Google Scholar 

  48. Edell-Gustafsson U, Angelhoff C, Johnsson E, Karlsson J, Morelius E. Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study. J Clin Nurs. 2015;24(5–6):717–27.

    Article  PubMed  Google Scholar 

  49. Jackson JC, Ely EW, Morey MC, Anderson VM, Denne LB, Clune J, et al. Cognitive and physical rehabilitation of intensive care unit survivors: results of the RETURN randomized controlled pilot investigation. Crit Care Med. 2012;40(4):1088–97.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Burns KEA, Devlin JW, Patient HNS. Family engagement in designing and implementing a weaning trial: a novel research paradigm in critical care. Chest. 2017;152:707.

    Article  PubMed  Google Scholar 

  51. Alessi C, Vitiello MV. Insomnia (primary) in older people: non-drug treatments. BMJ Clin Evid. 2015;pii:2302.

    Google Scholar 

  52. Hartescu I, Morgan K, Stevinson CD. Increased physical activity improves sleep and mood outcomes in inactive people with insomnia: a randomized controlled trial. J Sleep Res. 2015;24(5):526–34.

    Article  PubMed  Google Scholar 

  53. Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: a meta-analytic review. J Behav Med. 2015;38(3):427–49.

    Article  PubMed  Google Scholar 

  54. Owens RL, Huynh TG, Netzer G. Sleep in the intensive care unit in a model of family-centered care. AACN Adv Crit Care. 2017;28(2):171–8.

    Article  PubMed  Google Scholar 

  55. Busse M, Stromgren K, Thorngate L, Thomas KA. Parents’ responses to stress in the neonatal intensive care unit. Crit Care Nurse. 2013;33(4):52–9. quiz 60

    Article  PubMed  PubMed Central  Google Scholar 

  56. Lee SY, Kimble LP. Impaired sleep and Well-being in mothers with low-birth-weight infants. J Obstet Gynecol Neonatal Nurs. 2009;38(6):676–85.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Davydow DS, Hough CL, Langa KM, Iwashyna TJ. Depressive symptoms in spouses of older patients with severe sepsis. Crit Care Med. 2012;40(8):2335–41.

    Article  PubMed  PubMed Central  Google Scholar 

  58. van den Born-van Zanten SA, Dongelmans DA, Dettling-Ihnenfeldt D, Vink R, van der Schaaf M. Caregiver strain and posttraumatic stress symptoms of informal caregivers of intensive care unit survivors. Rehabil Psychol. 2016;61(2):173–8.

    Article  PubMed  Google Scholar 

  59. Cameron JI, Chu LM, Matte A, Tomlinson G, Chan L, Thomas C, et al. One-year outcomes in caregivers of critically ill patients. N Engl J Med. 2016;374(19):1831–41.

    Article  CAS  PubMed  Google Scholar 

  60. Comini L, Rocchi S, Bruletti G, Paneroni M, Bertolotti G, Vitacca M. Impact of clinical and quality of life outcomes of long-stay ICU survivors recovering from rehabilitation on caregivers’ burden. Respir Care. 2016;61(4):405–15.

    Article  PubMed  Google Scholar 

  61. Gallop KH, Kerr CE, Nixon A, Verdian L, Barney JB, Beale RJ. A qualitative investigation of patients’ and caregivers’ experiences of severe sepsis. Crit Care Med. 2015;43(2):296–307.

    Article  PubMed  Google Scholar 

  62. Cox CE, Docherty SL, Brandon DH, Whaley C, Attix DK, Clay AS, et al. Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregivers. Crit Care Med. 2009;37(10):2702–8.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Van Pelt DC, Schulz R, Chelluri L, Pinsky MR. Patient-specific, time-varying predictors of post-ICU informal caregiver burden: the caregiver outcomes after ICU discharge project. Chest. 2010;137(1):88–94.

    Article  PubMed  Google Scholar 

  64. Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med. 2012;40(2):502–9.

    Article  PubMed  Google Scholar 

  65. Cohen S, Kaplan Z, Zohar J, Cohen H. Preventing sleep on the first resting phase following a traumatic event attenuates anxiety-related responses. Behav Brain Res. 2017;320:450–6.

    Article  PubMed  Google Scholar 

  66. Kuriyama K, Soshi T, Kim Y. Sleep deprivation facilitates extinction of implicit fear generalization and physiological response to fear. Biol Psychiatry. 2010;68(11):991–8.

    Article  PubMed  Google Scholar 

  67. Porcheret K, Holmes EA, Goodwin GM, Foster RG, Wulff K. Psychological effect of an analogue traumatic event reduced by sleep deprivation. Sleep. 2015;38(7):1017–25.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Buysse DJ. Insomnia, depression and aging. Assessing sleep and mood interactions in older adults. Geriatrics. 2004;59(2):47–51. quiz 2

    PubMed  Google Scholar 

  69. Germain A, Buysse DJ, Nofzinger E. Sleep-specific mechanisms underlying posttraumatic stress disorder: integrative review and neurobiological hypotheses. Sleep Med Rev. 2008;12(3):185–95.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert L. Owens .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Jaiswal, S.J., Owens, R.L. (2018). Sleep and Sleep Deprivation Among Families in the ICU. In: Netzer, G. (eds) Families in the Intensive Care Unit. Springer, Cham. https://doi.org/10.1007/978-3-319-94337-4_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-94337-4_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-94336-7

  • Online ISBN: 978-3-319-94337-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics