A Systematic Review of Sleep Measurement in Critically Ill Patients
Background: Clinical trialists and clinicians have used a number of sleep quality measures to determine the outcomes of interventions to improve sleep and ameliorate the neurobehavioral consequences of sleep deprivation in critically ill patients, but findings have not always been consistent. To elu...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.542529/full |
| _version_ | 1811292932330749952 |
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| author | Kathy C. Richards Yan-yan Wang Yan-yan Wang Jeehye Jun Lichuan Ye |
| author_facet | Kathy C. Richards Yan-yan Wang Yan-yan Wang Jeehye Jun Lichuan Ye |
| author_sort | Kathy C. Richards |
| collection | DOAJ |
| description | Background: Clinical trialists and clinicians have used a number of sleep quality measures to determine the outcomes of interventions to improve sleep and ameliorate the neurobehavioral consequences of sleep deprivation in critically ill patients, but findings have not always been consistent. To elucidate the source of these consistencies, an important consideration is responsiveness of existing sleep measures. The purpose of an evaluative measure is to describe a construct of interest in a specific population, and to measure the extent of change in the construct over time. This systematic literature review identified measures of sleep quality in critically ill adults hospitalized in the Intensive Care Unit (ICU), and assessed their measurement properties, strengths and weaknesses, clinical usefulness, and responsiveness. We also recommended modifications, including new technology, that may improve clinical usefulness and responsiveness of the measures in research and practice.Methods: CINAHAL, PubMed/Medline, and Cochrane Library were searched from January 1, 2000 to February 1, 2020 to identify studies that evaluated sleep quality in critically ill patients.Results: Sixty-two studies using polysomnography (PSG) and other electroencephalogram-based methods, actigraphy, clinician observation, or patient perception using questionnaires were identified and evaluated. Key recommendations are: standard criteria are needed for scoring PSG in ICU patients who often have atypical brain waves; studies are too few, samples sizes too small, and study duration too short for recommendations on electroencephalogram-based measures and actigraphy; use the Sleep Observation Tool for clinician observation of sleep; and use the Richards Campbell Sleep Questionnaire to measure patient perception of sleep.Conclusions: Measuring the impact of interventions to prevent sleep deprivation requires reliable and valid sleep measures, and investigators have made good progress developing, testing, and applying these measures in the ICU. We recommend future large, multi-site intervention studies that measure multiple dimensions of sleep, and provide additional evidence on instrument reliability, validity, feasibility and responsiveness. We also encourage testing new technologies to augment existing measures to improve their feasibility and accuracy. |
| first_indexed | 2024-04-13T04:52:52Z |
| format | Article |
| id | doaj.art-d3f4906ed0194f8fabcd42c0c21705eb |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T04:52:52Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d3f4906ed0194f8fabcd42c0c21705eb2022-12-22T03:01:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-11-011110.3389/fneur.2020.542529542529A Systematic Review of Sleep Measurement in Critically Ill PatientsKathy C. Richards0Yan-yan Wang1Yan-yan Wang2Jeehye Jun3Lichuan Ye4University of Texas at Austin School of Nursing, Austin, TX, United StatesUniversity of Texas at Austin School of Nursing, Austin, TX, United StatesWest China Hospital, Sichuan University, Chengdu, ChinaDepartment of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United StatesSchool of Nursing, Bouve College of Health Sciences, Northeastern University, Boston, MA, United StatesBackground: Clinical trialists and clinicians have used a number of sleep quality measures to determine the outcomes of interventions to improve sleep and ameliorate the neurobehavioral consequences of sleep deprivation in critically ill patients, but findings have not always been consistent. To elucidate the source of these consistencies, an important consideration is responsiveness of existing sleep measures. The purpose of an evaluative measure is to describe a construct of interest in a specific population, and to measure the extent of change in the construct over time. This systematic literature review identified measures of sleep quality in critically ill adults hospitalized in the Intensive Care Unit (ICU), and assessed their measurement properties, strengths and weaknesses, clinical usefulness, and responsiveness. We also recommended modifications, including new technology, that may improve clinical usefulness and responsiveness of the measures in research and practice.Methods: CINAHAL, PubMed/Medline, and Cochrane Library were searched from January 1, 2000 to February 1, 2020 to identify studies that evaluated sleep quality in critically ill patients.Results: Sixty-two studies using polysomnography (PSG) and other electroencephalogram-based methods, actigraphy, clinician observation, or patient perception using questionnaires were identified and evaluated. Key recommendations are: standard criteria are needed for scoring PSG in ICU patients who often have atypical brain waves; studies are too few, samples sizes too small, and study duration too short for recommendations on electroencephalogram-based measures and actigraphy; use the Sleep Observation Tool for clinician observation of sleep; and use the Richards Campbell Sleep Questionnaire to measure patient perception of sleep.Conclusions: Measuring the impact of interventions to prevent sleep deprivation requires reliable and valid sleep measures, and investigators have made good progress developing, testing, and applying these measures in the ICU. We recommend future large, multi-site intervention studies that measure multiple dimensions of sleep, and provide additional evidence on instrument reliability, validity, feasibility and responsiveness. We also encourage testing new technologies to augment existing measures to improve their feasibility and accuracy.https://www.frontiersin.org/articles/10.3389/fneur.2020.542529/fullsleep measurementcritically ill patientICU—intensive care unitpolysomnographyactigraphysleep questionnaire |
| spellingShingle | Kathy C. Richards Yan-yan Wang Yan-yan Wang Jeehye Jun Lichuan Ye A Systematic Review of Sleep Measurement in Critically Ill Patients Frontiers in Neurology sleep measurement critically ill patient ICU—intensive care unit polysomnography actigraphy sleep questionnaire |
| title | A Systematic Review of Sleep Measurement in Critically Ill Patients |
| title_full | A Systematic Review of Sleep Measurement in Critically Ill Patients |
| title_fullStr | A Systematic Review of Sleep Measurement in Critically Ill Patients |
| title_full_unstemmed | A Systematic Review of Sleep Measurement in Critically Ill Patients |
| title_short | A Systematic Review of Sleep Measurement in Critically Ill Patients |
| title_sort | systematic review of sleep measurement in critically ill patients |
| topic | sleep measurement critically ill patient ICU—intensive care unit polysomnography actigraphy sleep questionnaire |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2020.542529/full |
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