Sleep and Circadian Rhythms in Mechanically Ventilated Patients

Sleep and Circadian Rhythms in Mechanically Ventilated Patients: a Feasibility and Mechanistic Study.

This study examines the feasibility of assessing sleep and circadian rhythmicity in critically ill patients undergoing mechanical ventilation. Secondarily, it will examine the feasibility of reducing subject exposure to environmental light and noise and of delivering routine care according to classical day/night routines.

Over 1 million patients develop respiratory failure annually in the United States; yet, the sleep of patients undergoing mechanical ventilation has received little attention. This protocol enrolls acutely ill medical patients undergoing mechanical ventilation. The feasibility of assessing sleep and circadian rhythmicity through the use of continuous bedside polysomnography and the measurement of core body temperature and urinary hormonal levels at frequent intervals will be explored. As a secondary goal, the feasibility of delivering routine care according to classical day/night routines, and of employing various noise and light reduction strategies at night, will be explored in a subset of subjects.

Inclusion Criteria:

• Adults undergoing mechanical ventilation in the medical intensive care unit.

Exclusion Criteria:

• Central nervous system disease (stroke, seizure, dementia, etc)
• Metabolic or hypoxic encephalopathy
• Confirmed or suspected drug overdose
• Currently receiving neuromuscular blockers
• Coma