Sleep
-
Randomized Controlled Trial
Sleep-facilitating effect of exogenous melatonin in healthy young men and women is circadian-phase dependent.
To investigate the effects of a physiologic and a pharmacologic dose of exogenous melatonin on sleep latency and sleep efficiency in sleep episodes initiated across a full range of circadian phases. ⋯ Exogenous melatonin administration possesses circadian-phase-dependent hypnotic properties, allowing for improved consolidation of sleep that occurs out of phase with endogenous melatonin secretion during the circadian night. The results support the hypothesis that both exogenous and endogenous melatonin attenuate the wake-promoting drive from the circadian system.
-
Critically ill patients are known to suffer from severely fragmented sleep with a predominance of stage I sleep and a paucity of slow wave and REM sleep. The causes of this sleep disruption include the intensive care unit (ICU) environment, medical illness, psychological stress, and many of the medications and other treatments used to help those who are critically ill. ⋯ This article reviews the literature on sleep disruption in the ICU, the effects of sepsis on sleep, the effects of commonly used ICU medications on sleep, the relationship between sleep and sedation, and the literature on the biological and psychological consequences of sleep deprivation specifically as it relates to the critically ill. Finally, an integrative approach to improving sleep in the ICU is described.