Sleepwake disorders in intensive care unit patients

Insomnia, hypersomnia, and sleep-related respiratory dysrhythmia are common in the acute medical, surgical, and neurological disorders for which the patients are admitted to the intensive care unit. These disturbances may be intense in severely ill patients requiring life-saving cardiorespiratory support. The noise, bright light, and constant activity in the unit interfere with sleep, and the drugs used in intensive care may add to this. A reversible confusional state may develop 3 to 7 days after admission secondary to sleep deprivation. In the surgical intensive care unit additional factors interfering with sleep include anaesthesia, pain, and metabolic disturbances or infection. REM behaviour disorder may occur in patients admitted to the intensive care unit. Intensive care unit patients often have excessive daytime sleepiness as a result of night sleep disturbance.

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