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Does improving sleep for the critically ill reduce the incidence and duration of delirium? An evidence-based review

by NSLHD Libraries (KL) on 2023-09-08T13:35:27+10:00 | 0 Comments

Rosalind Elliott RN, PhD, Lori Delaney RN, MN

Abstract

Delirium is associated with poor patient outcome. Critical-care nurses maintain that patients with disrupted sleep appear to develop delirium. We sought to explore whether improving sleep in the critically ill patients reduced the incidence and duration of delirium. Our review of five relevant studies suggests that there is low-quality evidence that improving sleep may reduce the incidence of delirium. The bidirectional association between delirium and sleep stymies research in this area, and thus, establishing cause and effect, is difficult. Research exploring other patient-centred outcomes, such as pain intensity, suggests that enhancing sleep may improve these outcomes.

What is known about the topic

  • Anecdotally nurses have always acknowledged that disrupted sleep was a potential delirium risk factor. This is not surprising since postulated neurotransmitter pathways and brain centres affected during delirium are central to sleep homeostasis and circadian rhythmicity.

What this paper adds

  • Studies suggest a need to greatly improve practice focused on creating the conditions for nocturnal rest, sleep and healthy circadian rhythms, and thus reduce the risk of delirium.
  • Delirium experts agree that measures to promote and maintain sleep may reduce the likelihood of delirium, and have other beneficial outcomes such as reduced pain intensity and stress and increased patient satisfaction.

Read the full article here:     https://doi.org/10.1111/nicc.12906

 

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