• Cornelius Engelmann, Jan Wallenborn, Derk Olthoff, Udo X Kaisers, and Henrik Rüffert.
• Department of Gastroenterology, Rheumatology and Hepatology, University Hospital Leipzig Liebigstrasse 20, 04103 Leipzig, Germany.
• Indian J Crit Care Med. 2014 Apr 1; 18 (4): 212-9.

ContextSleep deprivation is a common problem on intensive care units (ICUs) influencing not only cognition, but also cellular functions. An appropriate sleep-wake cycle should therefore be maintained to improve patients' outcome. Multiple disruptive factors on ICUs necessitate the administration of sedating and sleep-promoting drugs for patients who are not analgo-sedated.AimsThe objective of the present study was to evaluate sleep quantity and sleep quality in ICU patients receiving either propofol or flunitrazepam.Settings And DesignMonocentric, randomized, double-blinded trial.Materials And MethodsA total of 66 ICU patients were enrolled in the study (flunitrazepam n = 32, propofol n = 34). Propofol was injected continuously (2 mg/kg/h), flunitrazepam as a bolus dose (0.015 mg/kg). Differences between groups were evaluated using a standardized sleep diary and the bispectral index (BIS).Statistical Analysis UsedGroup comparisons were performed by Mann-Whitney U-Test. P < 0.05 was considered to be statistically significant.ResultsSleep quality and the frequency of awakenings were significantly better in the propofol group (Pg). In the same group lower BIS values were recorded (median BIS propofol 74.05, flunitrazepam 78.7 [P = 0.016]). BIS values had to be classified predominantly to slow-wave sleep under propofol and light sleep after administration of flunitrazepam. Sleep quality improved in the Pg with decreasing frequency of awakenings and in the flunitrazepam group with increasing sleep duration.ConclusionsContinuous low-dose injection of propofol for promoting and maintaining night sleep in ICU patients who are not analgo-sedated was superior to flunitrazepam regarding sleep quality and sleep structure.

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