Effects of Non-invasive Positive Pressure Ventilation on Sleep of Patients in Respiratory Intensive Care Unit Assessed by Overnight Polysomnography

Abstract

BackgroundSleep disorders are commonin RICU patients, with mechanical ventilation as one of the important factors leading to sleep disorders in RICU patients. Previous studies have mainly focused on the effect of invasive positive pressure ventilation (IPPV) on sleep in RICU patients, but there is no study on the effect of polysomnography on sleep in RICU patients with non-invasive positive pressure ventilation (NIPPV) .ObjectiveTo evaluate patients' sleep disorders and the effect of NIPPV on sleep in patients in respiratory intensive care unitsby overnight polysomnography.MethodsThe clinical data of 31 patients who underwent overnight polysomnography in the Department of Respiratory and Critical Care Medicine of Peking University First Hospital from May 2012 to August 2021 were retrospectively analyzed. The clinical data〔sex, age, height, body mass index, APACHEⅡscore, underlying diseases, main diagnosis, white blood cell count, hemoglobin, serum albumin, high-sensitivity C-reactive protein (hs-CRP) , arterial blood gas analysis, respiratory failure classification, total length of hospital stay, length of stay in RICU, RICU stay in the past 6 months, death during hospitalization〕, sleep characteristics 〔respiratory events: apnea-hypopnea index (AHI) , respiratory disturbance index (RDI) , total detection time, total sleep time, sleep latency, sleep efficiency, sleep stage: time, latency and proportion of REM and NREM, pulse oxygen: minimum pulse oxygen, average pulse oxygen during sleep, heart rate: minimum heart rate, maximum heart rate〕 of patients were collected. The patients were divided into NIPPV group and control group (non-NIPPV group) according to whether NIPPV treatment was performed during overnight polysomnography, and the clinical data and sleep characteristics of the two groups were compared.ResultsThere were 15 cases in the NIPPV group and 16 cases in the control group. Compared with the control group, the total sleep time (P=0.028) , REM sleep time (P=0.034) , NREM time (P=0.003) and N2 sleep time (P=0.003) were shortened in the NIPPV group, while the sleep efficiency (P=0.038) decreased, and the average heart rate increased (P=0.028) .ConclusionSleep disturbance is a common problem in RICU patients, and NIPPV patients are more likely to lead to decreased total sleep time, decreased REM sleep, and decreased sleep efficiency. It is recommended that RICU patients be routinely assessed with overnight polysomnography and given appropriate intervention to conduct appropriate interventions.

Keywords

• |sleep|intensive care units|sleep disorders|polysomnography|noninvasive ventilation|mechanical ventilation