verstoorde secretie van melatonine Disturbed biorhythm disturbed sleep
Conditions
Interventions
None listed
Sponsors
Philips
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: ICU patients > 18 years of age Expected stay in the ICU 48h or longer Capable of understanding and speaking Dutch Richmond agitation and sedation scale (RASS) * -3
Exclusion criteria
Exclusion criteria: Pre-existing history or treatment of sleep pathology, severe visual or hearing impairment, alcohol addiction or illicit drug abuse History of cognitive dysfunction (defined as dementia, traumatic brain injury, stroke or hepatic encephalopathy) Previously discharged from the ICU during this hospital admission Admission following neurosurgery (since underlying pathology, or the surgery itself, may interfere with sleep and cognitive function)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Correlation between sleep continuity and amplitude of melatonin secretion Interrater agreement between methods of sleep analysis (defined by Cohen*s Kappa): o R&K analysis and IDOS index o Somnolyzer score and IDOS index o Actigraphy and IDOS index Sleep-related parameters (using EEG: Rechtschaffen & Kales (R&K) manual scoring, and IDOS method): o total sleep time (any sleep stage other than awake, EEG) o number of awakenings and arousals o sleep efficiency o sleep continuity Biorhythm: o time and amplitude of concentration of melatonin secretion o minimum melatonin concentration o difference between peak and minimum | — |
Secondary
| Measure | Time frame |
|---|---|
| Cognitive and behavioural parameters: o ICU delirium by CAM-ICU o ICU delirium manifestation type defined by RASS-scores65 (hypo/hyperactive, or mixed) o duration of ICU delirium o clinical requirement for pharmacological intervention (haloperidol) Environmental parameters: o light levels (lux) o light frequencies o noise levels (decibel), and number of peaks exceeding 65dB o temperature (degrees Celsius) ICU and hospital length of stay Mortality (until ICU discharge, hospital discharge, 6 and 12 months after hospital discharge) Amount of administered opioids, benzodiazepines, sedatives and antipsychotics | — |
Countries
Netherlands
Outcome results
None listed