Assessment of sleep quality using cardiopulmonary coupling and its predictive value for delirium in ICU patients

Abstract

Objective

To assess sleep quality in intensive care unit (ICU) patients using cardiopulmonary coupling (CPC) analysis and explore its predictive value for delirium.

Method

ICU patients (n = 135) were divided into the delirium group (n = 44) and control group (n = 91) based on the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). CPC analysis was used to evaluate the sleep quality of all participants.

Result

Intergroup comparisons showed that total sleep time, stable sleep time, and sleep efficiency were significantly lower in the delirium group than in the control group, whereas unstable sleep time, rapid eye movement sleep time, wake-up time, stable sleep latency, and apnea-hypopnea index (AHI) were significantly higher in the delirium group than in the control group. Logistic regression analysis showed that advanced age and AHI were risk factors for delirium, whereas stable sleep time was a protective factor for delirium. Receiver operating characteristic (ROC) analysis showed that stable sleep time and stable sleep latency had a certain predictive value for delirium; the area under the ROC curve (AUC) for stable sleep time was higher (0.888 vs. 0.704). The cut-off value for stable sleep time was 0.65 h, with a sensitivity of 84.1 % and specificity of 81.3 %.

Conclusion

ICU patients with delirium have poorer sleep quality than patients without delirium. Stable sleep time derived from the CPC has a high predictive value for delirium and may serve as an objective indicator for its diagnosis.