Interrupção do sono na unidade de terapia intensiva: revisão integrativa acerca dos fatores associados

Abstract

Background: Sleep is a behavioural state characterized by decrease in responses to stimuli in the external environment. Is regulated by the central nervous system through physiological mechanisms and is divided into Non Rapid Eye Movement sleep (NREM) sleep and Rapid Eye Movement (REM). Has restorative function to the time it promotes relaxation. In the intensive care unit (ICU), complex environment and constant monitoring, technical activities are superimposed to the guarantee of quality of sleep patients sedated, causing the interruption of this process. Aim: Study aiming to describe the factors that are associated with the interruption of sleep in patients non sedated in the intensive care unit. Method: this is an integrative review, in which the search occurred through the databases: PUBMED, LILACS (American and Caribbean Literature in Health Sciences), Scielo (Scientific Electronic Library Online), Scopus, using the descriptors: intensive care units, sleep and patients, between years 2013 and 2018. Results: Among the elements that disrupt their sleep were identified as key: lighting, lot of noises in intensive care environment and excessive manipulations during the night. Other aspects observed include the perception of professionals about the importance of this physiological process, but not accompanied by actions that ensure your quality, such as the impact on brain function associated with your interruption. Conclusion: It was found that the environmental factors of the intensive care unit (ICU) interfere directly on sleep continuity, as well as the scarcity of protocols results in inadequate decision-making regarding the preservation of the rest of the time patient. Noises, excessive lighting and emotional patterns as the anxiety and fear are the major causes of interruption of sleep. The absence of protocols for promoting sleep in ICU implies the lack of appropriate actions performed by professionals. The occurrence of delirium due to decreased cognitive function, the decline of the immune system and the commitment of respiratory muscles complicating weaning from mechanical ventilation, were identified as the outcomes associated with the interruption of sleep critical patients.