Association between death and loss of stage N2 sleep features among critically Ill patients with delirium

Melissa P. Knauert, Emily J. Gilmore, Terrence E. Murphy, Henry K. Yaggi, Peter H. Van Ness, Ling Han, Lawrence J. Hirsch, Margaret A. Pisani

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Purpose: Critically ill patients experience significant sleep disruption. In this study of ICU patients with delirium, we evaluated associations between the loss of stage N2 features (K-complexes, sleep spindles), grade of encephalopathy based on electroencephalography (EEG), and intensive care unit (ICU) outcomes. We hypothesized that loss of stage N2 features is associated with more severe grades of encephalopathy and worse ICU outcomes including death. Materials and methods: This was an observational cohort study of 93 medical ICU patients without primary acute brain injury who underwent continuous EEG. Type and severity of critical illness, sedative-hypnotic use, length of stay, modified Rankin Scale at hospital discharge, and death during hospitalization were abstracted from the medical record. EEG was evaluated for grade of encephalopathy and sleep features. Results: Patients without K-complexes or without sleep spindles had more severe encephalopathy and higher odds of death. The odds ratio for patients without K-complexes was 18.8 (p =.046). The odds ratio for patients without sleep spindles was 6.3 (p =.036). Conclusions: Loss of stage N2 features is common and associated with more severe encephalopathy and higher odds of death. The absence of either Stage N2 feature, K complexes or sleep spindles, may have important prognostic value.

Original languageEnglish (US)
Pages (from-to)124-129
Number of pages6
JournalJournal of Critical Care
Volume48
DOIs
StatePublished - Dec 2018

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

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