Sleep Environment in an Tertiary Intensive Care Unit during a Double-Blind Randomized Controlled Trial

<bold>Background:</bold> Sleep disturbances are highly prevalent among patients admitted to the intensive care unit (ICU) and are strongly associated with adverse clinical outcomes. Understanding challenges of the ICU environment holds promise for mitigating these disturbances and ultimately improving patient outcomes. <bold>Objectives:</bold> This study aims to provide a detailed description of a cohort of ICU patients and elucidate the components of sleep environment, specifically light and noise. <bold>Methods:</bold> Data was collected from participants enrolled in a double-blind randomized controlled trial entitled “Exogenous Melatonin in Intensive Care Unit Chronodisruption-EMIC” (clinicaltrials.gov: <ext-link>NCT03708341</ext-link>). Descriptive data regarding patient demographics was documented. One-hour periods of illuminance and sound levels were recorded at the same hour twice daily (12AM-12PM) throughout the length of stay. <bold>Results:</bold> 163 patients were included in the study (54.6% male; mean age 67 ± 17 years). The mean APACHE II score for disease severity was 15 ± 6, the mean SOFA score was 5 ± 3, with a mean length of stay of 4 ± 5 days. Results are presented in Table 1. <table-wrap><object-id>erj;64/suppl_68/PA2689/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><label>Table 1</label><caption> Mean illuminance and sound levels </caption><table><colgroup><col></col><col></col><col></col><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td><bold>Sound (dB)¹</bold></td><td><bold>Illuminance (lux)²</bold></td></tr><tr><td><bold>AM</bold></td><td><bold>PM</bold></td><td><bold>AM</bold></td><td><bold>PM</bold></td></tr><tr><td><bold>Min</bold></td><td><bold>Max</bold></td><td><bold>Min</bold></td><td><bold>Max</bold></td><td><bold>Min</bold></td><td><bold>Max</bold></td><td><bold>Min</bold></td><td><bold>Max</bold></td></tr><tr><td>45.3</td><td>79.2</td><td>48</td><td>90.1</td><td>40</td><td>108.7</td><td>109.2</td><td>264.8</td></tr></tbody></table></table-wrap> ^{1. WHO threshold 45 dB for non-continuous noise to avoid negative sleep disturbances.} ^{2. 100 Lux is the minimal luminosity for reading.} <bold>Conclusion:</bold> Despite protocol efforts to control environmental factors, noise levels persist above the recommended WHO standards. Our study highlights suboptimal daytime luminosity and excessive nighttime luminosity, which may contribute to chronodisruption among patients.