TY - JOUR

T1 - Sleep quality and quantity determined by polysomnography in mechanically ventilated critically ill patients randomized to dexmedetomidine or placebo

AU - Oxlund, Jakob

AU - Knudsen, Torben

AU - Sörberg, Mikael

AU - Strøm, Thomas

AU - Toft, Palle

AU - Jennum, Poul Jørgen

N1 - Funding Information: An unrestricted grant of 70,000 euros and the study drug was provided by Orion Corporation. In addition, a grant of 33,000 euros was provided by Rigshospitalet and Odense University Hospitals' common research fund. The grants have in part covered PSG equipment, utensils, and salaries for study nurses and neurophysiology assistants. The researchers have no economic interests in the company and received no payment. Sponsor: Poul Jørgen Jennum.

PY - 2023

Y1 - 2023

N2 - Background: Abnormal sleep is commonly observed in the ICU and is associated with delirium and increased mortality. If sedation is necessary, it is often performed with gamma-aminobutyric acid agonists such as propofol or midazolam leading to an absence of restorative sleep. We aim to evaluate the effect of dexmedetomidine on sleep quality and quantity. Methods: Thirty consecutive patients were included. The study was conducted as a double-blinded, randomized, placebo-controlled trial with two parallel groups: 20 patients were treated with dexmedetomidine, and 10 with placebo. Two 16 h of polysomnography recordings were done for each patient on two consecutive nights. Patients were randomized to dexmedetomidine or placebo after the first recording, thus providing a control recording for all patients. Dexmedetomidine was administered during the second recording (6 p.m.–6 a.m.). Objective: To compare the effect of dexmedetomidine versus. placebo on sleep - quality and quantity. Primary outcome: Sleep quality, total sleep time (TST), Sleep efficiency (SE), and Rapid Eye Movement (REM) sleep determined by Polysomnography (PSG). Secondary outcome: Delirium and daytime function determined by Confusion Assessment Method of the Intensive Care Unit and physical activity. Alertness and wakefulness were determined by RASS (Richmond Agitation and Sedation Scale). Results: SE were increased in the dexmedetomidine group by; 37.6% (29.7;45.6 95% CI) versus 3.7% (−11.4;18.8 95% CI) (p <.001) and TST were prolonged by 271 min. (210;324 95% CI) versus 27 min. (−82;135 95% CI), (p <.001). No significant difference in REM sleep, delirium physical activity, or RASS score was found except for RASS night two. Conclusion: Total sleep time and sleep efficiency were significantly increased, without elimination of REM sleep, in mechanically ventilated ICU patients randomized to dexmedetomidine, when compared to a control PSG recording performed during non-sedation/standard care.

AB - Background: Abnormal sleep is commonly observed in the ICU and is associated with delirium and increased mortality. If sedation is necessary, it is often performed with gamma-aminobutyric acid agonists such as propofol or midazolam leading to an absence of restorative sleep. We aim to evaluate the effect of dexmedetomidine on sleep quality and quantity. Methods: Thirty consecutive patients were included. The study was conducted as a double-blinded, randomized, placebo-controlled trial with two parallel groups: 20 patients were treated with dexmedetomidine, and 10 with placebo. Two 16 h of polysomnography recordings were done for each patient on two consecutive nights. Patients were randomized to dexmedetomidine or placebo after the first recording, thus providing a control recording for all patients. Dexmedetomidine was administered during the second recording (6 p.m.–6 a.m.). Objective: To compare the effect of dexmedetomidine versus. placebo on sleep - quality and quantity. Primary outcome: Sleep quality, total sleep time (TST), Sleep efficiency (SE), and Rapid Eye Movement (REM) sleep determined by Polysomnography (PSG). Secondary outcome: Delirium and daytime function determined by Confusion Assessment Method of the Intensive Care Unit and physical activity. Alertness and wakefulness were determined by RASS (Richmond Agitation and Sedation Scale). Results: SE were increased in the dexmedetomidine group by; 37.6% (29.7;45.6 95% CI) versus 3.7% (−11.4;18.8 95% CI) (p <.001) and TST were prolonged by 271 min. (210;324 95% CI) versus 27 min. (−82;135 95% CI), (p <.001). No significant difference in REM sleep, delirium physical activity, or RASS score was found except for RASS night two. Conclusion: Total sleep time and sleep efficiency were significantly increased, without elimination of REM sleep, in mechanically ventilated ICU patients randomized to dexmedetomidine, when compared to a control PSG recording performed during non-sedation/standard care.

KW - critically ill

KW - dexmedetomidine

KW - polysomnography

KW - sleep-quality

KW - sleep-quantity

U2 - 10.1111/aas.14154

DO - 10.1111/aas.14154

M3 - Journal article

C2 - 36194395

AN - SCOPUS:85140223455

VL - 67

SP - 66

EP - 75

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 1

ER -