J Korean Crit Care Nurs.  2024 Oct;17(3):50-61. 10.34250/jkccn.2024.17.3.50.

Sleep Characteristics of Patients Admitted to Intensive Care Units after Major Abdominal Surgery

• Kang J
• Kang J

• KMID: 2560211
• DOI: http://doi.org/10.34250/jkccn.2024.17.3.50

Abstract

Purpose
: The aim of this study was to investigate sleep parameters and architecture in patients admitted to the intensive care unit (ICU) on the day of abdominal surgery.
Methods
: A total of ten patients who underwent laparotomy under general anesthesia at the hepatopancreatobiliary surgery department of a general hospital in Busan, South Korea participated in this observational study. We measured total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), and sleep stages on their first night in the ICU using the WatchPAT300. Furthermore, we used nonparametric statistics to examine differences in postoperative sleep based on sedative administration.
Results
: The Median (IQR) TST for the participants was 399.50(263.80) minutes; the SE was 75.1 (30.4)%; the WASO rate was 27.8(30.6)%; and the WASO frequency was 5.50(8.50) times. Patients’ rapid eye movement (REM) sleep time was 114.31(87.88) minutes, with 55.8(11.9)% of N1, 18.2(5.3)% of N2, and 24.8 (11.7)% of N3 sleep stages. The sedation group had a longer TST (Z=-2.619, p =.008), higher SE (Z=-2.611, p =.008), lower WASO rate (Z=-2.611, p =.008), smaller number of WASOs (Z=-2.627, p =.008), and longer REM sleep (Z=-2.617, p =.008) compared to the non-sedation group.
Conclusion
: We observed a high rate of light sleep and awakenings during sleep in patients admitted to the ICU after surgery. Moreover, non-sedated patients lacked either deep or REM sleep. Sleep-improving interventions are needed for non-sedated surgical patients who are admitted to the ICU.

Keyword

Hypnotics and sedatives, Intensive Care Units, Patients, Laparotomy, Sleep; 수면제, 진정제, 중환자실, 환자, 복부수술, 수면