Sleep quality and quantity determined by polysomnography in mechanically ventilated critically ill patients randomized to dexmedetomidine or placebo

Oct 4, 2022Acta anaesthesiologica Scandinavica

Sleep quality and amount measured in ventilated ICU patients given dexmedetomidine or placebo

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Abstract

increased by 37.6% in the dexmedetomidine group compared to 3.7% in the placebo group.

was prolonged by 271 minutes in the dexmedetomidine group versus 27 minutes in the placebo group.
No significant differences were observed in REM sleep between the two groups.
Delirium, physical activity, and alertness scores showed no significant differences, except for the RASS score on the second night.
The findings suggest that dexmedetomidine may improve sleep quality in mechanically ventilated ICU patients.

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BACKGROUND: Abnormal sleep is commonly observed in the ICU and is associated with delirium and increased mortality. If sedation is necessary, it is often performed with gamma-aminobutyric acid agonists such as propofol or midazolam leading to an absence of restorative sleep. We aim to evaluate the effect of dexmedetomidine on sleep quality and quantity.

METHODS: Thirty consecutive patients were included. The study was conducted as a double-blinded, randomized, placebo-controlled trial with two parallel groups: 20 patients were treated with dexmedetomidine, and 10 with placebo. Two 16 h of recordings were done for each patient on two consecutive nights. Patients were randomized to dexmedetomidine or placebo after the first recording, thus providing a control recording for all patients. Dexmedetomidine was administered during the second recording (6 p.m.-6 a.m.).

OBJECTIVE: To compare the effect of dexmedetomidine versus. placebo on sleep - quality and quantity.

PRIMARY OUTCOME: Sleep quality, (TST), (SE), and Rapid Eye Movement (REM) sleep determined by Polysomnography (PSG).

SECONDARY OUTCOME: Delirium and daytime function determined by Confusion Assessment Method of the Intensive Care Unit and physical activity. Alertness and wakefulness were determined by RASS (Richmond Agitation and Sedation Scale).

RESULTS: SE were increased in the dexmedetomidine group by; 37.6% (29.7;45.6 95% CI) versus 3.7% (-11.4;18.8 95% CI) (p < .001) and TST were prolonged by 271 min. (210;324 95% CI) versus 27 min. (-82;135 95% CI), (p < .001). No significant difference in REM sleep, delirium physical activity, or RASS score was found except for RASS night two.

CONCLUSION: Total sleep time and sleep efficiency were significantly increased, without elimination of REM sleep, in mechanically ventilated ICU patients randomized to dexmedetomidine, when compared to a control PSG recording performed during non-sedation/standard care.

Key numbers

37.6%

Increase in

Dexmedetomidine group vs. placebo group

271 min.

Increase

Dexmedetomidine group vs. placebo group

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Sleep quality and quantity determined by polysomnography in mechanically ventilated critically ill patients randomized to dexmedetomidine or placebo

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