Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital

Sleep and delirium in unsedated patients in the intensive care unit

Research output: Contribution to journalJournal articleResearchpeer-review


  1. AHA STEROID trial, dexamethasone in acute high-risk abdominal surgery, the protocol for a randomized controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Continuous monitoring of vital sign abnormalities; association to clinical complications in 500 postoperative patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Diagnostic criteria of CNS infection in patients with external ventricular drainage after traumatic brain injury: a pilot study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Development of a core outcome set for general intensive care unit patients - a protocol

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Sleep deprivation and delirium are major problems in the ICU. We aimed to assess the sleep quality by polysomnography (PSG) in relation to delirium in mechanically ventilated non-sedated ICU patients.

METHODS: Interpretation of 24-h PSG and clinical sleep assessment in 14 patients. Delirium assessment was done using the confusion assessment method for the intensive care unit (CAM-ICU).

RESULTS: Of four patients who were delirium free, only one had identifiable sleep on PSG. Sleep was disrupted with loss of circadian rhythm, and diminished REM sleep. In the remaining three patients the PSGs were atypical, meaning that no sleep signs were found, and sleep could not be quantified from the PSGs. Clinical total sleep time (ClinTST) ranged from 2.0-13.1 h in patients without delirium. Six patients with delirium all had atypical PSGs, so sleep could not be quantified. Short periods of REM sleep were found. ClinTST was median 8.5 h (range 0.4-13.8 h). EEG reactivity and wakefulness was found in all but one PSG. Four patients were CAM-ICU "unassessable" (unresponsive to voice). PSGs were atypical without reactivity or wakefulness, even though clinical wakefulness was documented. ClinTST was median 18.3 h (range 3.7-19.8 h). Paroxystic EEG activity was found in this subgroup.

CONCLUSIONS: The objective signs of sleep were absent in all but one PSG, so even though patients were not sedated, sleep could not be quantified. Even in patients without delirium, sleep could only be quantified in one of four patients. Paroxystic activity is frequent in unsedated patients, unresponsive to voice, but the implication is unknown.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Issue number1
Pages (from-to)59-68
Number of pages10
Publication statusPublished - Jan 2016

    Research areas

  • Adult, Aged, Aged, 80 and over, Circadian Rhythm, Conscious Sedation, Critical Care, Delirium, Electroencephalography, Female, Humans, Intensive Care Units, Male, Middle Aged, Polysomnography, Prospective Studies, Psychomotor Agitation, Respiration, Artificial, Sleep Deprivation, Sleep, REM, Wakefulness, Journal Article, Observational Study, Research Support, Non-U.S. Gov't

ID: 49649371