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Investigating the application of motion accelerometers as a sleep monitoring technique and the clinical burden of the intensive care environment on sleep quality: study protocol for a prospective observational study in Australia

Delaney, Lori; Currie, Marian J; Huang, Carol; Litton, Edward; Wibrow, Bradley; Lopez, Violeta; Van Haren, Frank

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Introduction: Sleep is a state of quiescence that facilitates the significant restorative processes that enhance individuals’ physiological and psychological well-being. Patients admitted to the intensive care unit (ICU) experience substantial sleep disturbance. Despite the biological importance of sleep, sleep monitoring does not form part of standard clinical care for critically ill patients. There exists an unmet need to assess the feasibility and accuracy of a range of sleep assessment...[Show more]

dc.contributor.authorDelaney, Lori
dc.contributor.authorCurrie, Marian J
dc.contributor.authorHuang, Carol
dc.contributor.authorLitton, Edward
dc.contributor.authorWibrow, Bradley
dc.contributor.authorLopez, Violeta
dc.contributor.authorVan Haren, Frank
dc.date.accessioned2021-11-09T00:14:58Z
dc.date.available2021-11-09T00:14:58Z
dc.identifier.issn2044-6055
dc.identifier.urihttp://hdl.handle.net/1885/251660
dc.description.abstractIntroduction: Sleep is a state of quiescence that facilitates the significant restorative processes that enhance individuals’ physiological and psychological well-being. Patients admitted to the intensive care unit (ICU) experience substantial sleep disturbance. Despite the biological importance of sleep, sleep monitoring does not form part of standard clinical care for critically ill patients. There exists an unmet need to assess the feasibility and accuracy of a range of sleep assessment techniques that have the potential to allow widespread implementation of sleep monitoring in the ICU. Key measures: The coprimary outcome measures of this study are to: determine the accuracy and feasibility of motion accelerometer monitoring (ie, actigraphy) and subjective assessments of sleep (nursing-based observations and patient self-reports) to the gold standard of sleep monitoring (ie, polysomnography) in evaluating sleep continuity and disturbance. The secondary outcome measures of the study will include: (1) the association between sleep disturbance and environmental factors (eg, noise, light and clinical interactions) and (2) to describe the sleep architecture of intensive care patients. Methods and analysis: A prospective, single centre observational design with a within subjects’ assessment of sleep monitoring techniques. The sample will comprise 80 adults (aged 18 years or more) inclusive of ventilated and non-ventilated patients, admitted to a tertiary ICU with a Richmond Agitation-Sedation Scale score between +2 (agitated) and −3 (moderate sedation) and an anticipated length of stay >24 hours. Patients’ sleep quality, total sleep time and sleep fragmentations will be continuously monitored for 24 hours using polysomnography and actigraphy. Behavioural assessments (nursing observations) and patients’ self-reports of sleep quality will be assessed during the 24-hour period using the Richards-Campbell Sleep Questionnaire, subjective sleepiness evaluated via the Karolinska Sleepiness Scale, along with a prehospital discharge survey regarding patients’ perception of sleep quality and disturbing factors using the Little Sleep Questionnaire will be undertaken. Associations between sleep disturbance, noise and light levels, and the frequency of clinical interactions will also be investigated. Sound and luminance levels will be recorded at 1 s epochs via Extech SDL600 and SDL400 monitoring devices. Clinical interactions will be logged via the electronic patient record system Metavision which documents patient monitoring and clinical care. Ethics and dissemination: The relevant institutions have approved the study protocol and consent procedures. The findings of the study will contribute to the understanding of sleep disturbance, and the ability to implement sleep monitoring methods within ICUs. Understanding the contribution of a clinical environment on sleep disturbance may provide insight into the need to address clinical environmental issues that may positively influence patient outcomes, and could dispel notions that the environment is a primary factor in sleep disturbance. The research findings will be disseminated via presentations at national and international conferences, proceedings and published articles in peer-reviewed journals.
dc.description.sponsorshipThis work is supported by the Canberra Hospital Foundation (ACT, Australia), VMedical Australia Pty Ltd and the Intensive Care Foundation Research Grant.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBMJ Publishing Group
dc.rights© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.sourceBMJ Open
dc.titleInvestigating the application of motion accelerometers as a sleep monitoring technique and the clinical burden of the intensive care environment on sleep quality: study protocol for a prospective observational study in Australia
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume8
dc.date.issued2018
local.identifier.absfor110310 - Intensive Care
local.identifier.ariespublicationu5234101xPUB67
local.publisher.urlhttp://bmjopen.bmj.com/
local.type.statusPublished Version
local.contributor.affiliationDelaney, Lori, College of Health and Medicine, ANU
local.contributor.affiliationCurrie, Marian J, Canberra Hospital
local.contributor.affiliationHuang, Carol, College of Health and Medicine, ANU
local.contributor.affiliationLitton, Edward, St John of God Subiaco Hospital
local.contributor.affiliationWibrow, Bradley, Sir Charles Gairdner Hospital
local.contributor.affiliationLopez, Violeta, Yong Loo Lin School of Medicine
local.contributor.affiliationVan Haren, Frank, College of Health and Medicine, ANU
local.bibliographicCitation.issue1
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage9
local.identifier.doi10.1136/bmjopen-2017-019704
local.identifier.absseo920199 - Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
dc.date.updated2020-11-23T11:45:38Z
local.identifier.scopusID2-s2.0-85051616733
dcterms.accessRightsOpen Access
dc.provenanceThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/
dc.rights.licenseCreative Commons Attribution Non Commercial (CC BY-NC 4.0) license
CollectionsANU Research Publications

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