The sleep deficiency and sleep disturbance of critically ill patients may result in adverse outcomes, negative effects on early rehabilitation, and may persist well beyond the intensive care unit (ICU). It has been paid more and more attention in clinical practice. The sleep problems of critically ill patients are associated with suffered critical illness, ICU environments, and coexisting sleep disorders before critical illness. Poor sleep quality, insufficient sleep duration, severe sleep fragmentation and irregular circadian rhythms during critical care illness have been extensively described. In addition, ICU patients have been specifically shown to experience atypical sleep and pathologic wakefulness. So the sleep in critical ill patients should be evaluated. Sleep can be evaluated by both subjective assessment and objective measurements, including polysomnography and actigraphy. According to individual situation, comprehensive, interdisciplinary, and personalized interventions, which include treating critical illness, improving ICU environment to reduce interference to sleep, nonpharmacological treatment to relax and stabilize sleep, and treating coexisting sleep disorders, should be taken to improve the patient's sleep and then to promote the early rehabilitation of critically ill patients.
危重症患者的睡眠不足和睡眠障碍可能导致不良的结局,影响患者早期康复,并延续为重症监护病房(ICU)睡眠障碍。临床中已逐渐受到重视。危重症患者的睡眠问题可能由于危重疾病本身、ICU环境及患病前合并的睡眠障碍共同导致,可以表现为睡眠质量降低、睡眠时间不足、睡眠严重碎片化、周期节律紊乱等,并出现ICU患者特有的“病理性觉醒”和“不典型睡眠”,应给予积极评估。睡眠评估方法包括主观评价和客观检查(包括多导睡眠监测和体动仪),根据患者个体情况采取多学科综合措施进行个体化干预,包括积极治疗原发危重疾病、改善ICU环境以减少其对患者的干扰因素、非药物疗法稳定睡眠、积极治疗共存的睡眠疾病,以期改善患者的睡眠状况,并促进危重症患者的早期康复。.