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Monitoring of nighttime EEG slow‐wave activity during dexmedetomidine infusion in patients with hyperactive ICU delirium: An observational pilot study
Author(s) -
AlaKokko Tero,
Erikson Kristo,
Koskenkari Juha,
Laurila Jouko,
Kortelainen Jukka
Publication year - 2022
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.14131
Subject(s) - dexmedetomidine , medicine , delirium , sedation , electroencephalography , anesthesia , dosing , sleep (system call) , intensive care unit , sleep disorder , sleep deprivation , intensive care medicine , insomnia , circadian rhythm , psychiatry , computer science , operating system
Abstract Background The disturbance of sleep has been associated with intensive care unit (ICU) delirium. Monitoring of EEG slow‐wave activity (SWA) has potential in measuring sleep quality and quantity. We investigated the quantitative monitoring of nighttime SWA and its association with the clinical evaluation of sleep in patients with hyperactive ICU delirium treated with dexmedetomidine. Methods We performed overnight EEG recordings in 15 patients diagnosed with hyperactive delirium during moderate dexmedetomidine sedation. SWA was evaluated by offline calculation of the C‐Trend Index, describing SWA in one parameter ranging 0 to 100 in values. Average and percentage of SWA values <50 were categorized as poor. The sleep quality and depth was clinically evaluated by the bedside nurse using the Richards‐Campbell Sleep Questionnaire (RCSQ) with scores <70 categorized as poor. Results Nighttime SWA revealed individual sleep structures and fundamental variation between patients. SWA was poor in 67%, sleep quality (RCSQ) in 67%, and sleep depth (RCSQ) in 60% of the patients. The category of SWA aligned with that of RCSQ‐based sleep quality in 87% and RCSQ‐based sleep depth in 67% of the patients. Conclusion Both, SWA and clinical evaluation suggested that the quality and depth of nighttime sleep were poor in most patients with hyperactive delirium despite dexmedetomidine infusion. Furthermore, the SWA and clinical evaluation classifications were not uniformly in agreement. An objective mode such as practical EEG‐based solution for sleep evaluation and individual drug dosing in the ICU setting could offer potential in improving sleep for patients with delirium.