Sleep during mechanical ventilation.

PURPOSE OF REVIEW: This review addresses the growing interest in the study of sleep during critical illness.

RECENT FINDINGS: We know that sleep, in all of its measurable aspects, is severely deranged in critically ill patients during mechanical ventilation. There is growing evidence that mode of mechanical ventilation, medications, and acuity of illness may contribute to such sleep derangements and that conventional factors such as noise and health care delivery may be playing a much smaller role than previously thought. Alternatively, changes in sleep-wakefulness state can alter patient-ventilator interaction, which may in turn influence physicians' decision-making. Sleep organization may predict functional outcome in patients with head trauma. Additionally, there is evidence that poor sleep is an important factor influencing long-term quality of life in survivors of critical illness.

SUMMARY: A more complete understanding of the etiopathogenesis of sleep derangements during mechanical ventilation may identify new interventions to help improve sleep, and possibly favorably influence short-term and long-term outcomes.