Sleep Deprivation and the ICU

Almost 70 percent of Americans face sleep deprivation every day. It prevents them from being able to focus and work properly leading to fatal accidents, such car accidents with people falling asleep at the wheel. If sleep deprivation is so detrimental to healthy people, what would its affect on people who are ill? For many patients sleep is essential in a speedy recovery, however, almost all patients suffer from the inability to sleep. Scientists Biren Kamdar, Dale Needham, and Nancy Collop all came together to study the correlation between sleep deprivation and process of recovery in patients. They found that both physical and physiological recoveries can be affected positively and/or negatively depending on the amount of sleep people get, therefore, it is imperative that the reason why patients are losing sleep is understood so they can have a successful recovery.  Due to external disturbances such as noise, light, other patient care, patients found in ICU’s do not get an adequate amount of sleep leading to problems with the heart, respiratory and immune systems, and cognitive functions.

In order to observe a patient’s sleeping pattern, the group of scientist devised several methods that allowed them to monitor a normal night’s sleep and then compare it to a sleep that had outside factors acting on it. They measured the changes in body temperature, changes in respiration, blood flow, and rapid eye movement. After that all they had to do is compare, which external sources affected to body in these areas, and with that the sources of sleep depravation were found.

Although ICU’s are excellent places for receiving care quickly and efficiently, it is not always the easiest place to fall asleep. Noise is a common factor and unfortunately is hard to avoid and with the fact “that critically ill patients may be more sensitive to environmental noise as they are recovering” (Kamdar pg.5) it makes the situation even worse. Noise and can from a variety of sources, but mainly coming from the staff as they talk amongst one another or interact with the other patients. Lighting is also another factor that the patients have to deal with. Although some patients claim, “that light is less disruptive to sleep than noise and patient care activities” (Kamdar pg. 5) it is still just another factor that can affect a good night’s sleep. The last disturbance is not a surprise: mechanical ventilation. It can be difficult to fall asleep when there is a tube stuck down your throat, but there also other problems that ventilation can cause including “increased ventilatory effort, abnormal gas exchange, and patient-ventilator dysynchrony” (Kamdar pg. 6). Although these are essential in keeping the patients alive, they are still impeding on their recovery, therefore these machines must be improved soon if patients are truly to receive the best care possible.

Each of one of these disturbances can lead to physical and or psychological problems while the patients are in the ICU the first of these being problems with the respiratory system. Leading not only to shortness of breath, patients who are not able to breath correctly due to sleep deprivation can suffer from severe muscle fatigue due to the lack of oxygen in their system, and in some extreme cases the results can lead to the airway collapsing all together. Sleep deprivation can also cause difficulty for a proper amount of blood to reach the heart, leading to an “increased risk of acute myocardial infarction” (Kamdar pg. 6) or better known as a heart attack. Not all of the problems caused are strictly physical though. Mental health is also known to be affected leading to delirium and cognitive dysfunction. Alone, these conditions can be easily treated and pose little risk to a person. However, in recovering patients, delirium can lead to an unsteady circadian rhythm (the human biological clock) making it even more difficult to get rest and even cause states of confusion. And even after release, if a patient suffered from either of these mental conditions, they are far more likely to develop severe depression. “A systematic review of 14 studies of post-ICU depression revealed clinically significant depression in 28% of patients within the first year of ICU discharge” (Kamdar pg. 9).

In Kamdar’s study “Sleep Deprivation in Critical Illness: Its Role in Physical and Psychological Recovery” it is clearly shown that sleep deprivation as an adverse affect on patients in their time of recovery. Hopefully, as studies progress, we will be able to create a scenario where all patients are able to receive the care they require, without being a detriment to their recovery. And although most UNC students are not in the ICU, I still think this article holds value. It shows that sleep loss can have many negative affects on the body’s health, therefore students have to make sure to get enough, otherwise it will become more difficult to succeed in schoolwork and other activities.

Works Cited:

Kamdar, Biren B., Dale M. Needham, and Nancy A. Collop "Sleep Deprivation in Critical Illness: Its Role in Physical and Psychological Recovery." Journal of Intensive Care Medicine (2009): 1-16. Print.