Sleep Disruption in Critically Ill Patients –Pharmacological Considerations


R. S. Bourne and G. H. Mills



Anaesthesia, 2004, 59, pg 374–384



Sleep disturbances are common in critically ill patients and contribute to morbidity. Environmental factors, patient care activities and acute illness are all potential causes of disrupted sleep. Additionally, it is important to consider drug therapy as a contributing factor to this adverse experience, which patients perceive as particularly stressful. Sedative and analgesic combinations used to facilitate mechanical ventilation are among the most sleep disruptive drugs. Cardiovascular, gastric protection, anti-asthma, anti-infective, antidepressant and anticonvulsant drugs have also been reported to cause a variety of sleep disorders. Withdrawal reactions to prescribed and occasionally recreational drugs should also be considered as possible triggers for sleep disruption. Tricyclic antidepressants and benzodiazepines are commonly prescribed in the treatment of sleep disorders, but have problems with decreasing slow wave and rapid eye movement sleep phases. Newer nonbenzodiazepine hypnotics offer little practical advantage. Melatonin and atypical antipsychotics require further investigation before their routine use can be recommended.



letteratura_pz critico cosciente_ptsd

A new frontier in critical care: saving the injuried brain.

Link veloci

Gestire il dolore

ico-flowchartdoloreFlowchart dolore

Gestire la sedazione

ico-flowchart-sedaz-agitFlowchart sedaz/agitaz

Gestire il delirium

ico-flowchart-deliriumFlowchart Delirium
ico-manuale-cam-icuManuale CAM-ICU
ico-schedalavoro-cam-icuScheda di lavoro CAM-ICU


Questo sito è stato realizzato grazie al contributo di:


Finanziamento per la Ricerca Indipendente
(Decreto DGS 13456 del 22 dicembre 2010)

Design by Pixelsparadise