Effects of Low Dose Sedation on Sleep Quality for Intensive Care Patients

Monday, 30 July 2012: 3:05 PM

Li-Yin Chang, RN
1.School of Nursing 2.Department of Nursing, 1.National Yang Ming University, 2.Taichung Veterans General Hospital, Taichung, Taiwan
Yann-Fen Chao, PhD
School of Nursing, Mackay Medicine, Nursing and Management College, Taipei, Taiwan

Learning Objective 1: To explore the effect of low dose Propofol on sleep quality for patients in intensive care units.

Learning Objective 2: To explore the difference of measurement tools on sleep quality for patients in intensive care units.

Purpose: to explore the effects of low-dose sedation on sleep quality in intensive care patients dependent on mechanical ventilation.

Methods: We designed a randomized, controlled trial (RCT) study. We measured the sleep quality with the miniature physiologic signal recorder, actigraphy, and the Richards-Campbell Sleep Questionnaire (RCSQ) for 48 hours. For the first 24 hours (8AM-8AM), we recorded baseline data (pretest). The experimental group (n=9) was given propofol 100-200 mg (1.5 mg/kg/h) in a continuous intravenous drip for 2 hours on the second day (10PM-12AM), the control group (n=12) deals with in standard care.

Results: The results revealed the sleep efficiency index for both groups was <85%, indicating poor sleep quality. The RCSQ score increased in the experimental group, especially the sleep depth sub-score.Sleep time was measured effectively by the miniature physiologic recorder, but actigraphy is not recommended for use in patients under sedation, long-term bed rest, or physical restraint.

Conclusion: ICU patients in these studies had poor sleep quality and the higher the sedative dosage, the more delusional their memories were. In the future, we need to develop objective tools to monitor sedative depth and sleep quality. An effective assessment protocol is required for monitoring the appropriate sedation depth to guarantee the safety of critical care patients.