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Half of the family members of critically ill patients experience excessive daytime sleepiness

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Abstract

Background

Sleepiness and fatigue are commonly reported by family members of intensive care unit (ICU) patients. Sleep deprivation may result in cognitive deficits. Sleep deprivation and cognitive blunting have not been quantitatively assessed in this population. We sought to determine the proportion of family members of ICU patients that experience excessive daytime sleepiness, sleep-associated functional impairment, and cognitive blunting.

Methods

Multicenter, cross-sectional survey of family members of patients admitted to ICUs at the University of Maryland Medical Center, Johns Hopkins University Hospital, and Christiana Hospital. Family members of ICU patients were evaluated using the Epworth Sleepiness Scale, a validated survey assessing sleepiness in everyday situations (normal, less than 10); the Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), a questionnaire quantifying the impact of sleepiness on daily activities (normal, at least 17.9); and psychomotor vigilance testing, a test of cognitive function, in relation to sleep deprivation (normal mean reaction time less than 500 ms).

Results

A total of 225 family members were assessed. Of these, 50.2 % (113/225) had Epworth scores consistent with excessive daytime sleepiness. Those with sleepiness experienced greater impairment in performing daily activities by FOSQ-10 (15.6 ± 3.0 vs 17.4 ± 2.2, p < 0.001). Cognitive blunting was found in 13.3 % (30/225) of family members and 15.1 % (14/93) of surrogate decision-makers. Similar rates of cognitive blunting as reported by mean reaction time of at least 500 ms were found among family members whether or not they reported sleepiness (15.0 % (17/113) vs. 11.6 % (13/112), p = 0.45).

Conclusions

Half of the family members of ICU patients suffer from excessive daytime sleepiness. This sleepiness is associated with functional impairment, but not cognitive blunting.

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Acknowledgments

We thank the nurses and family members of the participating ICUs for their time and participation in this study. Roy Brower, MD contributed to the questionnaire design and study conception. Helpful criticism was received from Theodore Iwashyna, MD, PhD. Dr. Netzer thanks Eric Zager, MD for making the completion of this study possible. Dr. Verceles receives support from NIA P30 AG028747, and Dr. Netzer is supported by NIH K12RR023250.

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, 110 S. Paca St., Second Floor, Baltimore, MD, 21201, USA

    Avelino C. Verceles, Majid Afshar, Michael T. McCurdy, Carl Shanholtz, Marc T. Zubrow, Jennifer Titus & Giora Netzer

  2. University of Maryland Claude D. Pepper Older Americans Independence Center, University of Maryland School of Medicine and the Baltimore VA Medical Center Geriatric Research, Education and Clinical Center, Baltimore, MD, USA

    Avelino C. Verceles

  3. Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Douglas S. Corwin

  4. Pulmonology Associates, Main Line Health Lankenau Hospital, Wynnewood, PA, USA

    Eliot B. Friedman

  5. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA

    Karen Oakjones

  6. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA

    Giora Netzer

Authors
  1. Avelino C. Verceles
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  2. Douglas S. Corwin
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  3. Majid Afshar
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  8. Marc T. Zubrow
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  9. Jennifer Titus
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  10. Giora Netzer
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Corresponding author

Correspondence to Avelino C. Verceles.

Additional information

Take-home message: Half of the family members of intensive care unit patients suffer from excessive daytime sleepiness. This sleepiness results in functional impairment, with a proportion of family members also demonstrating cognitive blunting.

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Verceles, A.C., Corwin, D.S., Afshar, M. et al. Half of the family members of critically ill patients experience excessive daytime sleepiness. Intensive Care Med 40, 1124–1131 (2014). https://doi.org/10.1007/s00134-014-3347-z

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  • DOI: https://doi.org/10.1007/s00134-014-3347-z

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