The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift

Intensive neurological assessments in neurocritical care settings for unduly prolonged period result in profound sleep deprivation in those patients that confounds the true neurological status of these patients, and the mounting apprehension in providers can beget a vicious cycle of even more intens...

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Main Authors: Kislay Kishore, Michael D. Cusimano
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-06-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2021.637250/full
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author Kislay Kishore
Michael D. Cusimano
author_facet Kislay Kishore
Michael D. Cusimano
author_sort Kislay Kishore
collection DOAJ
description Intensive neurological assessments in neurocritical care settings for unduly prolonged period result in profound sleep deprivation in those patients that confounds the true neurological status of these patients, and the mounting apprehension in providers can beget a vicious cycle of even more intensive neurological assessments resulting in further sleep deprivation from being constantly woken up to be “assessed.” This iatrogenic state drives these patients into deep sleep stages that impact spontaneous breathing trials, weaken immunity, and lead to unwarranted investigations and interventions. There is dwindling value of prolonged frequent neurochecks beyond the initial 24–48 h of an intracranial event. We insist that sleep must be considered on at least an equal par to other functions that are routinely assessed. We reason that therapeutic sleep must be allowed to these patients in suitable amounts especially beyond the first 36–48 h to achieve ideal and swift recovery. This merits a paradigm shift.
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spelling doaj.art-b28d12f595e440dd8bcbcb2aba4d9f602022-12-21T20:25:14ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-06-011210.3389/fneur.2021.637250637250The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm ShiftKislay KishoreMichael D. CusimanoIntensive neurological assessments in neurocritical care settings for unduly prolonged period result in profound sleep deprivation in those patients that confounds the true neurological status of these patients, and the mounting apprehension in providers can beget a vicious cycle of even more intensive neurological assessments resulting in further sleep deprivation from being constantly woken up to be “assessed.” This iatrogenic state drives these patients into deep sleep stages that impact spontaneous breathing trials, weaken immunity, and lead to unwarranted investigations and interventions. There is dwindling value of prolonged frequent neurochecks beyond the initial 24–48 h of an intracranial event. We insist that sleep must be considered on at least an equal par to other functions that are routinely assessed. We reason that therapeutic sleep must be allowed to these patients in suitable amounts especially beyond the first 36–48 h to achieve ideal and swift recovery. This merits a paradigm shift.https://www.frontiersin.org/articles/10.3389/fneur.2021.637250/fullsleep deprivation in neurocritical caretherapeutic sleepfrequency of neuromonitoringsleep assessment in neurocritical careneed for sleep for recovery
spellingShingle Kislay Kishore
Michael D. Cusimano
The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift
Frontiers in Neurology
sleep deprivation in neurocritical care
therapeutic sleep
frequency of neuromonitoring
sleep assessment in neurocritical care
need for sleep for recovery
title The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift
title_full The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift
title_fullStr The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift
title_full_unstemmed The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift
title_short The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift
title_sort fundamental need for sleep in neurocritical care units time for a paradigm shift
topic sleep deprivation in neurocritical care
therapeutic sleep
frequency of neuromonitoring
sleep assessment in neurocritical care
need for sleep for recovery
url https://www.frontiersin.org/articles/10.3389/fneur.2021.637250/full
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