Circadian disruption of ICU patients: A review of pathways, expression, and interventions

J Crit Care. 2017 Apr:38:269-277. doi: 10.1016/j.jcrc.2016.12.006. Epub 2016 Dec 13.

Abstract

Intensive care unit patients typically exhibit pathologic wakefulness, poor quality of daytime sleep, nocturnal sleep fragmentation, and sleep patterns that feature the absence of slow wave sleep and rapid eye movement. This article offers a review of the existing literature examining circadian desynchronization in critically ill patients, highlighting contributing factors identified by scholars, and circadian abnormalities observed in these patients. It discusses potential implications for clinical practice and suggests avenues of future research. Elucidating the role of circadian rhythms in the management of critical illness can guide future chronotherapeutic approaches and optimize patient outcomes.

Keywords: Circadian rhythms; Critical illness; Factors; Interventions.

Publication types

  • Review

MeSH terms

  • Chronobiology Disorders / metabolism
  • Chronobiology Disorders / physiopathology*
  • Circadian Rhythm*
  • Clinical Alarms
  • Critical Care
  • Critical Illness*
  • Humans
  • Intensive Care Units*
  • Light / adverse effects
  • Melatonin / metabolism
  • Noise / adverse effects
  • Nutritional Support
  • Respiration, Artificial
  • Sleep
  • Sleep Deprivation
  • Sleep, REM

Substances

  • Melatonin