Improving the Sleep and Circadian Rhythms of Mechanically Ventilated Patients

Improving the Sleep and Circadian Rhythms of Mechanically Ventilated Patients

The goal of this project is to determine whether the sleep and circadian rhythms of critically ill patients undergoing mechanical ventilation can be improved through practical strategies that can be employed at the bedside.

Nearly 1 million patients develop respiratory failure annually in the United States; yet, the sleep of patients undergoing mechanical ventilation has received little attention. This project is designed to characterize sleep and circadian rhythmicity in critically ill patients and to explore the efficacy of a non-pharmacological intervention to improve sleep and normalize circadian phase. The study will examine the effect of a protocol employing noise reduction and enforcement of a robust light-dark cycle on sleep quality and circadian rhythmicity. A secondary analysis will examine the relationship between delirium and sleep disruption and loss of circadian rhythmicity. Circadian rhythmicity will be characterized through the measurement of urinary 6-sulfatoxymelatonin levels at frequent intervals, while sleep will be assessed using continuous polysomnography.

Inclusion Criteria:

• Age 18 years or older
• Receiving mechanical ventilation and intravenous sedation

Exclusion Criteria:

• Debilitating central nervous system disease or degenerative disorder
• Active seizures
• Persistent coma
• Renal failure requiring dialysis
• Expected to be extubated within 24 hours
• Currently receiving neuromuscular blocker