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Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement
Journal article   Open access   Peer reviewed

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

Melissa P Knauert, Najib T Ayas, Karen J Bosma, Xavier Drouot, Mojdeh S Heavner, Robert L Owens, Paula L Watson, M Elizabeth Wilcox, Brian J Anderson, Makayla L Cordoza, …
American journal of respiratory and critical care medicine, Vol.207(7), e49
04/01/2023
DOI: 10.1164/rccm.202301-0184ST
PMCID: PMC10111990
PMID: 36999950
url
https://doi.org/10.1164/rccm.202301-0184ST View
Published (Version of record) Open Access

Abstract

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. 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. 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. 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.
 critical illness circadian rhythm sleep deficiency research priority delirium

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