- Paper Report
- Open Access
Sleep disorders following ICU discharge
- Richard Venn1
© Current Science Ltd 2000
- Published: 1 June 2000
- Central sleep apnoea
- obstructive sleep apnoea
- sleep-related breathing disorder
There remains a significant hospital mortality for patients who survive an ICU stay and are discharged to the ward. Several studies have shown sleep disorders and nocturnal hypoxaemia in post-operative patients, which may result in ischaemic events and potential morbidity and mortality. This study examines whether these problems may exist in patients discharged from the ICU.
Prospective, consecutive patient study (n = 15) performing overnight pneumographic sleep studies, simple spirometry and Epworth sleepiness score (ESS) on patients who had received more than 48 h of IPPV in the ICU.
Studies performed on the ward within 72 h of discharge from the ICU.
Control group (n = 10, fit, healthy, volunteers) underwent identical studies.
Abnormal respiratory events recorded and identified as obstructive, central or hypopnoeas.
Exclusions: known sleep apnoea, COPD, CCF, neuromuscular disorders.
The control group showed a normal ESS, normal pneumographic studies, no significant oxygen desaturations, and had a body mass index (BMI) in the normal range. In the patient group, sedation and analgesia had been provided with various combinations of propofol, midazolam, morphine and fentanyl, whilst in the ICU. All patients had a normal ESS. The majority of patients who were able to perform spirometry showed significant reductions in both forced expiratory volume 1 and forced vital capacity. Three patients had BMI > 25 kg/m2 and one patient had a BMI > 30 kg/m2. Oxygen therapy was prescribed to all patients, but 13/15 patients still had episodes of nocturnal hypoxaemia. Nine patients had SaO2< 90% for longer than 2 h. The number of patients with pneumographic abnormalities differs between the text and table in the actual paper but it appears that the majority had respiratory events and they were predominantly hypopnoeas in origin. Three out of four patients with a high BMI had obstructive apnoeas, but hypopnoeas also occurred.