Abstract
Introduction: Sleep disruption and deprivation is a continuing problem in the Intensive Care Unit, but measures to improve sleep cannot utilize traditional polysomnography. Practical, non-intrusive diagnostic monitoring of sleep is required.
Aim: To: 1) test two new portable ambulatory sleep diagnostic devices to monitor sleep in ICU and 2) compare sleep data generated by the different devices.
Methods: The devices were a) WatchPAT 200 (Itamar Medical), wrist watch-style, employing peripheral arterial tone and actigraphy to evaluate sleep time and sleep stage by an automatic algorithm (PAT device) and b) ALICE PDx (Respironics Philips), miniature polysomnographic device utilizing EEG and EMG recordings, with technician scoring (Mini-PSG device). Both include oximetry and position sensors. Seven ICU patients provided informed consent (mean age 68 years) and were recorded wearing both devices, from 2100 to 0600.
Results: Both devices successfully monitored sleep in ICU patients. The PAT device was less intrusive with size and attachments. Saturation and heart rate oximetry data were identical from the devices: Both devices calculated total sleep time (TST), and detected changing sleep stage. There were significant differences in reported values. Mean TST reported was 365 and 507 min., for Mini-PSG and PAT device, respectively, difference 28%. Similarly, REM sleep time was 7.9 and 16.1%TST for the devices, difference 51%. There was large inter-patient variance; some patients showed similar results from both devices.
Conclusions: Portable sleep diagnostic devices can successfully monitor sleep in ICU patients. Devices based on different sensor recordings may generate different calculations of sleep time and stage.
- © 2011 ERS
