Commentary on lik S, Oztekin D, Akyolcu N and Iever H (2005) Sleep disturbance: the patient care activities applied at the night shift in the intensive care unit. Journal of Clinical Nursing 14, 102-106

摘要

Sleep is utterly central to our lives and our well-being. Unfortunately, when people are sick enough to be in hospital, they are in an environment which is for the most part hostile to sleep. Intensive care units (ICUs) are probably the least restful places in hospitals due to the high levels of nursing and other activities 24 hours a day, painful conditions, invasive procedures, environmental noise and anxiety. This is not a new problem, but it seems that it is a very persistent one. This paper by Celik et al. is a welcome reminder to all those who work in this field that action is needed to minimize night-time disruptions in ICUs.Probably the earliest mention in the nursing literature of how difficult it is to sleep in ICU was almost 30 years ago. A small US study monitored sleep using electroencephalogram and showed that the nine patients they observed in ICU only got 2.4 hours sleep over 24 hours (Hilton 1976). This was later shown also to be the case in the UK, where a similar study again of nine ICU patients showed that they had less than two hours sleep in 48 (Aurell & Elmqvist 1985). Since that time, sophisticated (and noisy) equipment has proliferated, and a series of studies has described the difficulties of creating a restful environment where intensive therapy is delivered round the clock (e.g. Gabor et al. 2003). A few have assessed the effectiveness of interventions designed to improve the sleep of ICU patients, such as reductions in noise and light levels (e.g. Walder et al. 2000) and the masking of noise (e.g. Williamson 1992).