Poster Presentations: Wednesday, October 26, 2011 |

A Pilot Study to Validate Portable Sleep Recording as a Tool by Which to Accurately Assess Sleep Quality in Critically Ill Patients FREE TO VIEW

Vipin Malik, MD; Stephen Frankel, MD; John Harrington, DO; Teofilo Lee-Chiong, MD
Chest. 2011;140(4_MeetingAbstracts):808A. doi:10.1378/chest.1116596
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PURPOSE: In critically ill, mechanically ventilated patients, continuous standard EEG monitoring cannot be used to monitor sleep in the ICU.

METHODS: Critically ill patients with septic shock and acute respiratory failure requiring mechanical ventilation were enrolled in the study. Portable sleep monitoring device was connected to 11 leads including C4M1/O1M2 EEGx2, EOGx2, EMGx2, EKGx2 and a ground channel and recorded continuously for a 24-hour period. Collected data was scored manually as well as using automated software.

RESULTS: Manual scoring of the data from seven patients enrolled so far showed the following findings: PT 1 PT 2 PT 3 PT 4 PT 5 PT 6 PT 7 N1% 2.5 36 29 33 27 5 26 N2% 81 63 67 67 68 91 74 N3% 16 0 5 0 0.5 0 0 R% 0.04 1 0 0.5 5 4 0 SE% 94 87 76 82 75 82 57 WASO 80 170 196 206 339 201 552 AI 9.4 13.9 44.8 10.6 22.9 15.4 4.9 TST 1197 1152 640 1109 1063 1239 817 TRT 1278 1322 837 1353 1415 1440 1440 WASO=Wake After Sleep Onset AI=Arousal Index TST= Total Sleep Time TRT= Total Recording Time PT=Patient

CONCLUSIONS: 1. Portable sleep recording devices with two EEG channels can be used to objectively assess sleep versus awake stages in critically ill patients. 2. Majority of the sleep in critically ill patients is spent in N1 and N2. 3. There is near complete absence of N3 and R. 4. Sleep efficiency is lower than expected but acceptable given continuous infusion of Propofol with daily sedation vacation. 5. WASO and AI are both high in managing critically ill patients. 6. There are only finite number of epochs that are classified as W because of uninterpretable EEG. 7. Automated scoring had increased percentage of N3 due to artifacts interpreted as delta waves.

CLINICAL IMPLICATIONS: Portable sleep recording devices can be used to assess sleep in critically ill patients and allow further research into medication/environmental interventions that could improve sleep efficiency and quality. Data collection is ongoing to increase the power of the study.

DISCLOSURE: The following authors have nothing to disclose: Vipin Malik, Stephen Frankel, John Harrington, Teofilo Lee-Chiong

Portable sleep monitoring devices have been FDA approved for home sleep testing but have not been used in critical care setting.

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