Sleep in Elderly Patients under Prolonged Mechanical Ventilation: An Observational Study

Introduction: Sleep typically becomes more disturbed with age. Similarly, the quantity and quality of sleep in patients undergoing critical care in the intensive care unit is usually disrupted. The aim of the current study was to evaluate the sleep conditions of elderly adults with prolonged mechanical ventilation (PMV) in a respiratory care center (RCC). Methods: It was a three-stage prospective observational study, which aimed to evaluate the patient's subjective sleep quality, their circadian rhythm, and objective sleep parameters. The Richards-Campbell sleep questionnaire (RCSQ), 24-hour body temperature measurements, and 24-hour polysomnography (PSG) were used to assess these features, respectively in patients undergoing PMV therapy. Results: Eight elderly participants completed 30 RCSQ surveys, and the average total score was 52.9 +/- 20.3. Among the 19 elderly subjects who had their 24-hour body temperatures measured, only 21.1% were assessed as having a normal body temperature circadian rhythm. A total of 6 elderly patients underwent 24-hour PSG and their mean recording time was 22.8 +/- 0.8 hours. The total sleep time was 411.1 +/- 247.6 minutes, and the time spent in sleep stages N1, N2, N3 and REM was 23.1%, 70.1%, 3.3% and 3.5% of total sleep, respectively. The majority of sleep (61.5 +/- 14.5% of total sleep) occurred intermittently during the day as opposed to at night. Sleep efficiency was 33.7 +/- 26.9% at night. Conclusions: Elderly patients receiving PMV in the RCC presented with poor subjective sleep quality, disrupted circadian rhythms, and disturbed and fragmented sleep. Copyright (C) 2021, Taiwan Society of Geriatric Emergency & Critical Care Medicine.