{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T02:31:55Z","timestamp":1788057115977,"version":"build-2784847793"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,7,28]],"date-time":"2019-07-28T00:00:00Z","timestamp":1564272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Atypical <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> patterns not consistent with standard sleep staging criteria have been observed in medical intensive care unit (<jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>) patients. Our aim was to examine the relationship between sleep architecture and sedation in critically ill mechanically ventilated patients pre\u2010 and post\u2010extubation. We performed a prospective observational repeated measures study where 50 mechanically ventilated patients with 31 paired analyses were examined at an academic medical centre. The sleep efficiency was 58.3\u00a0\u00b1\u00a025.4% for intubated patients and 45.6\u00a0\u00b1\u00a025.4% for extubated patients (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.02). Intubated patients spent 76.33\u00a0\u00b1\u00a03.34% of time in non\u2010rapid eye movement (<jats:styled-content style=\"fixed-case\">NREM<\/jats:styled-content>) sleep compared to 64.66\u00a0\u00b1\u00a04.06% of time for extubated patients (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.02). <jats:styled-content style=\"fixed-case\">REM<\/jats:styled-content> sleep constituted 1.36\u00a0\u00b1\u00a00.67% of total sleep time in intubated patients and 2.06\u00a0\u00b1\u00a01.09% in extubated patients (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.58). Relative sleep atypia was higher in intubated patients compared to extubated patients (3.38\u00a0\u00b1\u00a00.87 versus 2.79\u00a0\u00b1\u00a00.42; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Eleven patients were sedated with propofol only, 18 patients with fentanyl only, 11 patients with fentanyl and propofol, and 10 patients had no sedation. The mean sleep times on \u201cpropofol\u201d, \u201cfentanyl\u201d, \u201cpropofol and fentanyl,\u201d and \u201cno sedation\u201d were 6.54\u00a0\u00b1\u00a00.64, 4.88\u00a0\u00b1\u00a00.75, 6.20\u00a0\u00b1\u00a00.75 and 4.02\u00a0\u00b1\u00a00.62\u00a0hr, respectively. The sigma\/alpha values for patients on \u201cpropofol\u201d, \u201cfentanyl\u201d, \u201cpropofol and fentanyl\u201d and \u201cno sedation\u201d were 0.69\u00a0\u00b1\u00a00.04, 0.54\u00a0\u00b1\u00a00.01, 0.62\u00a0\u00b1\u00a00.02 and 0.57\u00a0\u00b1\u00a00.02, respectively. Sedated patients on mechanical ventilation had higher sleep efficiency and more atypia compared to the same patients following extubation. Propofol was associated with higher sleep duration and less disrupted sleep architecture compared to fentanyl, propofol and fentanyl, or no sedation.<\/jats:p>","DOI":"10.1111\/jsr.12894","type":"journal-article","created":{"date-parts":[[2019,7,28]],"date-time":"2019-07-28T23:53:15Z","timestamp":1564357995000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effects of deep sedation on sleep in critically ill medical patients on mechanical ventilation"],"prefix":"10.1111","volume":"29","author":[{"given":"Raymonde","family":"Jean","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Icahn School of Medicine at Mount Sinai Mount Sinai St. Luke's and Mount Sinai West New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purav","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine University of Florida Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Yudelevich","sequence":"additional","affiliation":[{"name":"Department of Medicine Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Genese","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Wake Forest Baptist Medical Center Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Gershner","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine NYU Langone Health New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Levendowski","sequence":"additional","affiliation":[{"name":"Advanced Brain Monitoring Carlsbad California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Martillo","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and Surgery The Mount Sinai Hospital New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iazsmin","family":"Ventura","sequence":"additional","affiliation":[{"name":"Department of Rheumatology University of Chicago Pritzker School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirban","family":"Basu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine New York\u2010Presbyterian\/Queens Hospital Flushing New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pius","family":"Ochieng","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine University of Pittsburgh Medical Center Susquehanna Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5244-5234","authenticated-orcid":false,"given":"Charlisa D.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine NYU Langone Health New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/31.11.1559"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000260055.64235.7C"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181743f41"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199804000-00015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.117.3.809"},{"issue":"6","key":"e_1_2_8_7_1","first-page":"531","article-title":"Development of the American association of critical\u2010care nurses\u2019 sedation assessment scale for critically ill patients","volume":"14","author":"De Jong M. 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