AB053. Sleep characteristics of patients weaning from invasive mechanical ventilation

Background: Quality of sleep in mechanically ventilated patients is influenced by several factors, such as patients’ overall condition, medication, environmental conditions and ventilation mode. Aim of the study was to evaluate patients’ sleep characteristics during weaning from mechanical ventilation (MV) in 2 consecutive nights: with the patient under MV followed by a sleep study with spontaneous respiration (SR).

Methods: The study was conducted in the Intensive Care Unit of “G. Papageorgiou” General Hospital and in the Respiratory Intermediate Care Unit of the Pulmonary Department of “G. Papanikolaou” General Hospital, Thessaloniki, Greece. It included 16 stable, not sedated patients, with GCS >12, without infections, in pressure support ventilation (PSV) mode. A full polysomnography was conducted during the weaning period within 2 consecutive nights. On the first night, the patients were on MV and the second night on SR.

Results: Included were 11 males and 5 females, with mean age 46.5±24.5 years. Mean sleep efficiency was poor, both in SR and under MA [(70.6±18.2)% vs. (67.1±22.4)%, respectively, P=0.836], with lower REM sleep percentage [(7.56±7.59)% vs. (10.7±7.8)% respectively, P=0.156]. A significant difference was observed in time to REM sleep onset (145.3±71.0 vs. 92.21±89.3 min, respectively, P=0.046). No significant difference was found in sleep stages’ duration but a longer duration of WASO and N1 stage and a shorter N3 stage were observed in patients on SR. The average and minimum SpO2 of the patients during sleep were low on SR [(95.19±3.22)% and (95.23±3.33)% respectively], without significant difference from sleep on MV [(89.94±4.77)% and (89.46±5.91)% respectively, P=0.777]. More hypopneas were observed in sleep on SR (2.3±3.2 vs. 0.43±0.74/hour, P=0.037), in comparison with sleep under MV.

Conclusions: Patients’ sleep during weaning from MV is of low quality and tends to deteriorate during SR. Respiratory function during SR exhibits similar tendency.

Keywords: Mechanical ventilation (MV); quality of life; sleep quality