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

Details

• Personal Author:
  Anderson BJ ; Ayas NT ; Bosma KJ ; Cordoza ML ; Devlin JW ; Drouot X ; Elliott R ; Gehlbach BK ; Girard TD ; Heavner MS ; Kamdar BB ; Knauert MP ; Korwin AS ; Lusczek ER ; Owens RL ; Parthasarathy S ; Spies C ; Sunderram J ; Telias I ; Watson PL ; Weinhouse GL ; Wilcox ME ; Zee PC
• Description:
  Background: 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. Methods: We convened a multidisciplinary group with relevant expertise to participate in an American Thoracic Society Workshop. Workshop objectives included identifying ICU SCD subtopics of interest, key knowledge gaps, and research priorities. Members attended remote sessions from March to November 2021. Recorded presentations were prepared and viewed by members before Workshop sessions. Workshop discussion focused on key gaps and related research priorities. The priorities listed herein were selected on the basis of rank as established by a series of anonymous surveys. Results: We identified the following research priorities: establish an ICU SCD definition, further develop rigorous and feasible ICU SCD measures, test associations between ICU SCD domains and outcomes, promote the inclusion of mechanistic and patient-centered outcomes within large clinical studies, leverage implementation science strategies to maximize intervention fidelity and sustainability, and collaborate among investigators to harmonize methods and promote multisite investigation. Conclusions: ICU SCD is a complex and compelling potential target for improving ICU outcomes. Given the influence on all other research priorities, further development of rigorous, feasible ICU SCD measurement is a key next step in advancing the field. [Description provided by NIOSH]
• Subjects:
  Circadian Rhythm Health Care Facilities Workforce And Services Occupational Health Safety Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  Author Keywords: Sleep Deficiency Biological Rhythms Circadian Rhythm Circadian Rhythms Clinical Techniques Critical Illness Delirium Health Care Facilities Medical Management Guidelines Research Priority Sleep Deprivation

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Arizona ; California ; Connecticut ; Illinois ; Massachusetts ; Minnesota ; New Jersey ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 9 ; Pennsylvania ; Tennessee
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  207
• Issue:
  7
• NIOSHTIC Number:
  nn:20067581
• Citation:
  Am J Respir Crit Care Med 2023 Apr; 207(7):e49-e68
• Contact Point Address:
  Melissa P. Knauert, M.D., Ph.D., Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057
• Email:
  melissa.knauert@yale.edu
• Federal Fiscal Year:
  2023
• Performing Organization:
  RBHS-Robert Wood Johnson Medical School, Piscataway, New Jersey
• Peer Reviewed:
  True
• Start Date:
  20210701
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• End Date:
  20240630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1b893be53e401dab4c4519231f475d58a486da9721598f45f4332d7ff547a7f8c28a40cb55aae2fcaa334a34452b115571f5f994fb3be088a85eebc0303df430
• Download URL:
  https://stacks.cdc.gov/view/cdc/231506/cdc_231506_DS1.pdf
• File Type:
  [PDF - 1.60 MB ]