Browsing by Author "Henríquez-Beltrán, Mario"

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    Nonpharmacological interventions to promote sleep in the adult critical patients unit: a scoping review
    (Elsevier Ireland Ltd, 2025) Carrera Fabia, María Paz; Alegría Vargas, Leyla; Brockmann Veloso, Pablo Edmundo; Repetto Lisboa, Paula Beatriz; Leonard, Douglas; Cádiz, Rodrigo; Paredes, Fabio; Rojas Gualy, Idalid; Moya Digmann, Ana Verónica; Oviedo Alvarez, Vanessa Andrea; García, Patricio; Henríquez-Beltrán, Mario; Bakker, Jan
    Background: Sleep and circadian rhythms are markedly altered in intensive care unit (ICU) patients. Numerous factors related to the patient and the ICU environment affect the ability to initiate and maintain sleep. Therefore, nonpharmacological interventions could play an essential role in improving sleep and circadian rhythm. Objective: The aim of this study was to examine nonpharmacological interventions evaluated for promoting sleep in adult ICUs. Methods: A scoping review was conducted, including randomised controlled trials, nonrandomised controlled trials, quasi-experimental trials, and other controlled studies investigating the effects of nonpharmacological interventions promoting sleep in adult ICU patients. Results: A total of 57 articles and 14 ongoing trials were included in the review, of which 38 were randomised clinical trials. Nine nonpharmacological interventions to improve sleep in critically ill patients were evaluated: earplugs and/or eye masks, aromatherapy, bundles, music intervention, massage or acupressure, noise masking, bright light, and dynamic light. Most included trials simultaneously assessed the effect of more than one intervention on perceived sleep quality using questionnaires. The association between the interventions and improved sleep varied. In the case of multicomponent interventions, it is difficult to identify which components might have influenced sleep improvement. Conclusions: Numerous studies have evaluated various nonpharmacological interventions to promote sleep in critically ill patients, several of which improved perceived sleep quality. However, the substantial variability of the assessed interventions and their implementation complicates drawing reliable conclusions. Registration: The protocol for this scoping review was registered with the Open Science Framework under the identifier https://doi.org/10.17605/OSF.IO/MPEQ5.
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    The trajectory of sleep after critical illness: a 24-month follow-up study
    (2025) Henríquez-Beltrán, Mario; Benítez, Iván D.; Vaca, Rafaela; Santisteve, Sally; Aguilà, Maria; Vila, Anna; Minguez, Olga; Rodríguez-Muñoz, Carlos; Galán-González, Anna; Carvalho-Brugger, Sulamita; González, Paula; Rodríguez, Paula; Caballero, Jesús; Barberà, Carme; Torres, Gerard; Labarca Trucios, Gonzalo Patricio; Malla-Banyeres, Mar; Moncusí-Moix, Anna; Torres, Antoni; de Gonzalo-Calvo, David; Barbé, Ferran; González, Jessica; Targa, Adriano D. S.
    Abstract Background Survivors of critical illness endure long-lasting physical and mental challenges. Despite the persistence of poor sleep quality in a considerable proportion of patients at the 12-month follow-up, studies with assessments exceeding this period are limited. We aimed to investigate the trajectory of sleep over the 24 months following critical illness. Methods Observational, prospective study. Patients diagnosed with SARS-CoV-2 infection were recruited during the intensive care unit stay. Evaluations of sleep (Pittsburgh Sleep Quality Index [PSQI]), mental health (Hospital Anxiety and Depression Scale [HADS]), quality of life (12-item Short Form Survey [SF-12]), and other factors were performed in the short-term, and at 12 and 24 months after hospital discharge. Good sleep quality was defined as a PSQI score of ≤ 5. Minimal clinically important improvement (MCII) was defined as a decrease of ≥ 4 points in the PSQI score between the short-term assessment and the 24-month follow-up. Results The cohort included 196 patients (69.9% males), with a median [p25;p75] age of 62.0 [53.0;67.2] years. The global population showed a mean (95% CI) change of − 0.91 ( − 1.50 to − 0.31) points in the PSQI score from the short-term assessment to the 24-month follow-up. Based on PSQI score trajectories, three distinct groups of patients were identified: (i) the healthy group, consisting of patients with good sleep quality in the short-term that was maintained throughout the follow-up period; (ii) the MCII group, consisting of patients with poor sleep quality in the short-term, but with improvement over time, ultimately reaching levels comparable to the healthy group; (iii) the non-MCII group, consisting of those with consistently poor sleep quality across the entire follow-up. Further analyses revealed that PSQI score trajectories were closely aligned with those of the HADS and SF-12 mental scores. Conclusions Our findings reveal that a subset of critical illness survivors requires up to 24 months after the acute phase to fully restore their sleep quality, while a significant proportion does not experience a clinically significant improvement in sleep quality over this period. These distinct sleep trajectories are strongly correlated with mental health status, highlighting the importance of addressing sleep alongside mental health within the framework of post-intensive care syndrome.