Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors

Sophia Wang,1–3 Jared W Meeker,4 Anthony J Perkins,5 Sujuan Gao,5 Sikandar H Khan,4,6 Ninotchka L Sigua,4,7 Shalini Manchanda,4,7 Malaz A Boustani,2,3,6,8 Babar A Khan3,4,6,8 1Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202 USA; 2Center for Health In...

Full description

Bibliographic Details
Main Authors: Wang S, Meeker JW, Perkins AJ, Gao S, Khan SH, Sigua NL, Manchanda S, Boustani MA, Khan BA
Format: Article
Language:English
Published: Dove Medical Press 2019-03-01
Series:International Journal of General Medicine
Subjects:
Online Access:https://www.dovepress.com/psychiatric-symptoms-and-their-association-with-sleep-disturbances-in--peer-reviewed-article-IJGM
_version_ 1818520601658130432
author Wang S
Meeker JW
Perkins AJ
Gao S
Khan SH
Sigua NL
Manchanda S
Boustani MA
Khan BA
author_facet Wang S
Meeker JW
Perkins AJ
Gao S
Khan SH
Sigua NL
Manchanda S
Boustani MA
Khan BA
author_sort Wang S
collection DOAJ
description Sophia Wang,1–3 Jared W Meeker,4 Anthony J Perkins,5 Sujuan Gao,5 Sikandar H Khan,4,6 Ninotchka L Sigua,4,7 Shalini Manchanda,4,7 Malaz A Boustani,2,3,6,8 Babar A Khan3,4,6,8 1Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202 USA; 2Center for Health Innovation and Implementation Science, Clinical and Translational Science Institute, Indianapolis, IN, USA; 3Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN, USA; 4Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; 5Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA; 6IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN, USA; 7Indiana University Health Sleep Disorders Center, Indiana University School of Medicine, Indianapolis, IN, USA; 8Division of Geriatrics and General Internal Medicine, Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA Background: Sleep disturbances in critically ill patients are associated with poorer long-term clinical outcomes and quality of life. Studies are needed to better characterize associations and risk factors for persistent sleep disturbances after intensive care unit (ICU) discharge. Psychiatric disorders are frequently associated with sleep disturbances, but the role of psychiatric symptoms in sleep disturbances in ICU survivors has not been well-studied. Objective: To examine the association between psychiatric symptoms and sleep disturbances in ICU survivors. Methods: 112 adult ICU survivors seen from July 2011 to August 2016 in the Critical Care Recovery Center, an ICU survivor clinic at the Eskenazi Hospital in Indianapolis, IN, USA, were assessed for sleep disturbances (insomnia, hypersomnia, difficulty with sleep onset, difficulty with sleep maintenance, and excessive daytime sleepiness) and psychiatric symptoms (trauma-related symptoms and moderate to severe depressive symptoms) 3 months after ICU discharge. A multivariate logistic regression model was performed to examine the association between psychiatric symptoms and sleep disturbances. Analyses were controlled for age, hypertension, history of depression, and respiratory failure. Results: ICU survivors with both trauma-related and depression symptoms (OR 16.66, 95% CI 2.89–96.00) and trauma-related symptoms alone (OR 4.59, 95% CI 1.11–18.88) had a higher likelihood of sleep disturbances. Depression symptoms alone were no longer significantly associated with sleep disturbances when analysis was controlled for trauma-related symptoms. Conclusion: Trauma-related symptoms and trauma-related plus moderate to severe depressive symptoms were associated with a higher likelihood of sleep disturbances. Future studies are needed to determine whether psychiatric symptoms are associated with objective changes on polysomnography and actigraphy and whether adequate treatment of psychiatric symptoms can improve sleep disturbances. Keywords: sleep disturbance, post-traumatic stress disorder, depression, ICU survivor, psychiatric disorders, post-intensive care syndrome
first_indexed 2024-12-11T01:39:39Z
format Article
id doaj.art-7184a5169e9f45ef8a4cec71cc5cc058
institution Directory Open Access Journal
issn 1178-7074
language English
last_indexed 2024-12-11T01:39:39Z
publishDate 2019-03-01
publisher Dove Medical Press
record_format Article
series International Journal of General Medicine
spelling doaj.art-7184a5169e9f45ef8a4cec71cc5cc0582022-12-22T01:25:05ZengDove Medical PressInternational Journal of General Medicine1178-70742019-03-01Volume 1212513044703Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivorsWang SMeeker JWPerkins AJGao SKhan SHSigua NLManchanda SBoustani MAKhan BASophia Wang,1–3 Jared W Meeker,4 Anthony J Perkins,5 Sujuan Gao,5 Sikandar H Khan,4,6 Ninotchka L Sigua,4,7 Shalini Manchanda,4,7 Malaz A Boustani,2,3,6,8 Babar A Khan3,4,6,8 1Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202 USA; 2Center for Health Innovation and Implementation Science, Clinical and Translational Science Institute, Indianapolis, IN, USA; 3Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN, USA; 4Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; 5Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA; 6IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN, USA; 7Indiana University Health Sleep Disorders Center, Indiana University School of Medicine, Indianapolis, IN, USA; 8Division of Geriatrics and General Internal Medicine, Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA Background: Sleep disturbances in critically ill patients are associated with poorer long-term clinical outcomes and quality of life. Studies are needed to better characterize associations and risk factors for persistent sleep disturbances after intensive care unit (ICU) discharge. Psychiatric disorders are frequently associated with sleep disturbances, but the role of psychiatric symptoms in sleep disturbances in ICU survivors has not been well-studied. Objective: To examine the association between psychiatric symptoms and sleep disturbances in ICU survivors. Methods: 112 adult ICU survivors seen from July 2011 to August 2016 in the Critical Care Recovery Center, an ICU survivor clinic at the Eskenazi Hospital in Indianapolis, IN, USA, were assessed for sleep disturbances (insomnia, hypersomnia, difficulty with sleep onset, difficulty with sleep maintenance, and excessive daytime sleepiness) and psychiatric symptoms (trauma-related symptoms and moderate to severe depressive symptoms) 3 months after ICU discharge. A multivariate logistic regression model was performed to examine the association between psychiatric symptoms and sleep disturbances. Analyses were controlled for age, hypertension, history of depression, and respiratory failure. Results: ICU survivors with both trauma-related and depression symptoms (OR 16.66, 95% CI 2.89–96.00) and trauma-related symptoms alone (OR 4.59, 95% CI 1.11–18.88) had a higher likelihood of sleep disturbances. Depression symptoms alone were no longer significantly associated with sleep disturbances when analysis was controlled for trauma-related symptoms. Conclusion: Trauma-related symptoms and trauma-related plus moderate to severe depressive symptoms were associated with a higher likelihood of sleep disturbances. Future studies are needed to determine whether psychiatric symptoms are associated with objective changes on polysomnography and actigraphy and whether adequate treatment of psychiatric symptoms can improve sleep disturbances. Keywords: sleep disturbance, post-traumatic stress disorder, depression, ICU survivor, psychiatric disorders, post-intensive care syndromehttps://www.dovepress.com/psychiatric-symptoms-and-their-association-with-sleep-disturbances-in--peer-reviewed-article-IJGMSleep disturbancepost-traumatic stress disorderdepressionICU survivor
spellingShingle Wang S
Meeker JW
Perkins AJ
Gao S
Khan SH
Sigua NL
Manchanda S
Boustani MA
Khan BA
Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors
International Journal of General Medicine
Sleep disturbance
post-traumatic stress disorder
depression
ICU survivor
title Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors
title_full Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors
title_fullStr Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors
title_full_unstemmed Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors
title_short Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors
title_sort psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors
topic Sleep disturbance
post-traumatic stress disorder
depression
ICU survivor
url https://www.dovepress.com/psychiatric-symptoms-and-their-association-with-sleep-disturbances-in--peer-reviewed-article-IJGM
work_keys_str_mv AT wangs psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT meekerjw psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT perkinsaj psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT gaos psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT khansh psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT siguanl psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT manchandas psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT boustanima psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors
AT khanba psychiatricsymptomsandtheirassociationwithsleepdisturbancesinintensivecareunitsurvivors