Assessment and Monitoring of Sleep in the Intensive Care Unit.
Maya N Elías
PMID 34023079WHAT IT FOUND
Routine physiologic sleep monitoring is not recommended in the ICU.
Nurses should assess sleep using validated questionnaires or informal nursing assessment, and interpret observed sleep cautiously because it can overestimate sleep.
Key findings
01Current ICU guidelines do not recommend routine physiologic sleep monitoring with polysomnography, electroencephalography, bispectral analysis, or actigraphy.
02Nurses should routinely assess patients' sleep using a validated assessment tool, such as the RCSQ, or by informal nursing assessment and/or electronic medical record documentation.
03Nursing observation can mistake awake but immobile patients as asleep and tends to overestimate total sleep time compared with polysomnography.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a review, not a new study with original methods and results. Actigraphy has not undergone rigorous validation against polysomnography in the ICU setting. Nursing observation tends to overestimate total sleep time compared with polysomnography. Patient questionnaires can only be used when patients are cognitively able to participate. Physiologic monitoring has not been adequately studied for outcomes such as delirium, duration of mechanical ventilation, ICU length of stay, or ICU mortality.
The easy way to misread this
Do not conclude that nursing observation or actigraphy provides an accurate measure of ICU sleep. These methods can overestimate sleep, especially when patients are immobile, sedated, or mechanically ventilated.