Asleep and awake in the ICU

Abstract

Sleep is essential for homeostasis, recovery and survival. The functional importance of sleep is perhaps best illustrated by observing the detrimental effects of sleep deprivation, as commonly experienced by hospitalized patients and occasionally by staff too. Our most vulnerable patients require intensive care around the clock, blurring the lines between day and night for those receiving and providing care. Meanwhile nurses, physicians, and researchers depend on legacy tools to expand our understanding of individual factors impacting sleep. Due to this limited understanding of the complex interplay between sleep, critical illness, circadian timekeeping, critical care, and environmental factors, broad efforts to improve patients’ sleep have seen limited success. Even well considered and targeted interventions may therefore be expected to interfere with natural sleep in unintended ways. This thesis describes a series of challenges and opportunities to improve our patients sleep when they may need it most