Noise-sensitivity during sleep in non-sedated mechanically ventilated patients is associated with weaning duration: a polysomnographic study.

Background: Poor sleep is a major concern in intensive care units (ICUs), particularly in mechanically ventilated patients, because it is associated with longer duration of the weaning phase and higher mortality. High noise levels in ICUs are frequently reported by patients as one of the most disturbing sleep-disrupting factors but would be responsible for less than 20% of arousals. This suggests major inter-individual variability in noise sensitivity.

Sleep Deprivation in Healthy Males Increases Muscle Afferents, Impairing Motor Preparation and Reducing Endurance.

Purpose: Sleep deprivation (SD) reduces time to task failure during endurance exercises. The aim of our work was to study the effect of acute SD on the endurance of a skeletal hand muscle and to investigate cortical motor drive to muscle and perception of effort.

Methods: Origin of the early exhaustion after SD might be insufficient cortical motor drive to muscle or motor inhibition because of excessive perception of effort.

[Sleep in intensive care: a crucial but little-known issue].

A CRUCIAL BUT LITTLE-KNOWN ISSUE. Polysomnography is the best tool to study sleep in intensive care unit (ICU), but this recording is complex to perform in such environment. Sleep alterations in ICU patients are specific and include electroencephalographic abnormalities during sleep and wake, rendering sleep scoring more complicated.

Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement.

Sleep and circadian disruption (SCD) is common and severe in the ICU. On the basis of rigorous evidence in non-ICU populations and emerging evidence in ICU populations, SCD is likely to have a profound negative impact on patient outcomes. Thus, it is urgent that we establish research priorities to advance understanding of ICU SCD.

A real-time automated sleep scoring algorithm to detect refreshing sleep in conscious ventilated critically ill patients.

Objectives: Due to the noisy environment, a very large number of patients admitted to intensive care units (ICUs) suffer from sleep severe disruption. These sleep alterations have been associated with a prolonged need for assisted ventilation or even with death. Sleep scoring in the critically ill is very challenging and requires sleep experts, limiting relevant studies to a few experienced teams.

Agonist Delivery by High-Flow Nasal Cannula During COPD Exacerbation.

Background: Whereas high-flow nasal cannula (HFNC) oxygen therapy is increasingly used in patients with exacerbation of COPD, the effectiveness of agonist nebulization through HFNC has been poorly assessed. We hypothesized that salbutamol vibrating-mesh nebulization through HFNC improves pulmonary function tests in subjects with COPD.

Methods: We conducted a physiological crossover study including subjects admitted to the ICU for severe exacerbation of COPD.

Narcolepsy Type 1: A Remitting Disease? An Unusual Case Report.

We describe the case of a male patient who was diagnosed with narcolepsy type 1 on the basis of sleep and wake symptoms, and the results of investigations including video-polysomnography, multiple sleep latency test, human leukocyte antigen status and orexin level in cerebrospinal fluid. During the first years after disease onset, the patient did not show any significant improvement despite treatment with a variety of stimulant and anti-cataplectic drugs. However, spontaneous remission of disease occurred after 15 years.

Role of sleep on respiratory failure after extubation in the ICU.

Background: Sleep had never been assessed immediately after extubation in patients still in the ICU. However, sleep deprivation may alter respiratory function and may promote respiratory failure. We hypothesized that sleep alterations after extubation could be associated with an increased risk of post-extubation respiratory failure and reintubation.

Sleep deprivation reduces vagal tone during an inspiratory endurance task in humans.

Study Objectives: Sleep deprivation alters inspiratory endurance by reducing inspiratory motor output. Vagal tone is involved in exercise endurance. This study aimed to investigate the effect of sleep deprivation on vagal tone adaptation in healthy subjects performing an inspiratory effort.

A Systematic Review of Risk Factors for Sleep Disruption in Critically Ill Adults.

Objectives: Numerous risk factors for sleep disruption in critically ill adults have been described. We performed a systematic review of all risk factors associated with sleep disruption in the ICU setting.

Data Sources: PubMed, EMBASE, CINAHL, Web of Science, Cochrane Central Register for Controlled Trials, and Cochrane Database of Systematic Reviews.

Impact of Sleep Deprivation on Respiratory Motor Output and Endurance. A Physiological Study.

Sleep deprivation can alter endurance of skeletal muscles, but its impact on respiratory command is unknown. We aimed to assess the effect of sleep deprivation on respiratory motor output and inspiratory endurance. Inspiratory endurance was investigated twice in random order, following a normal sleep night and a sleepless night.

Sleep and Pathological Wakefulness at the Time of Liberation from Mechanical Ventilation (SLEEWE). A Prospective Multicenter Physiological Study.

Abnormal patterns of sleep and wakefulness exist in mechanically ventilated patients. In this study (SLEEWE [Effect of Sleep Disruption on the Outcome of Weaning from Mechanical Ventilation]), we aimed to investigate polysomnographic indexes as well as a continuous index for evaluating sleep depth, the odds ratio product (ORP), to determine whether abnormal sleep or wakefulness is associated with the outcome of spontaneous breathing trials (SBTs). Mechanically ventilated patients from three sites were enrolled if an SBT was planned the following day.

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU.

Objective: To update and expand the 2013 Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the ICU.

Design: Thirty-two international experts, four methodologists, and four critical illness survivors met virtually at least monthly. All section groups gathered face-to-face at annual Society of Critical Care Medicine congresses; virtual connections included those unable to attend.

Impact of sleep alterations on weaning duration in mechanically ventilated patients: a prospective study.

Sleep is markedly altered in intensive care unit (ICU) patients and may alter respiratory performance. Our objective was to assess the impact of sleep alterations on weaning duration.We conducted a prospective physiological study at a French teaching hospital.

Comorbidity between central disorders of hypersomnolence and immune-based disorders.

Objective: To assess and compare the frequencies of personal and family history of autoimmune diseases (AID), autoinflammatory disorders (ID), and allergies in a population of patients, adults and children, with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH), 3 central hypersomnia disorders, and healthy controls.

Methods: Personal and family history of AID, ID, and allergies were assessed by questionnaire and medical interview in a large cohort of 450 consecutive adult patients (206 NT1, 106 NT2, 138 IH) and 95 pediatric patients (80 NT1) diagnosed according to the third International Classification of Sleep Disorders criteria in national reference centers for narcolepsy in France and 751 controls (700 adults, 51 children) from the general population.

Results: Ten adults with NT1 (4.