Evidence map›Paper›PMID 26071825›Full record

SynthesisThe American journal of medicine2015

A meta-analysis of sleep-promoting interventions during critical illness.

Chithra Poongkunran, Santosh G John, Arun S Kannan, Safal Shetty, Christian Bime, Sairam Parthasarathy

Open access · bronzeAbstract readMeta-Analysis
In one paragraph

Synthesis in The American journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Chithra PoongkunranDepartment of Medicine, University of Arizona, Tucson.
Santosh G JohnDepartment of Medicine, University of Arizona, Tucson.
Arun S KannanDepartment of Medicine, University of Arizona, Tucson.
Safal ShettyDepartment of Medicine, University of Arizona, Tucson; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Arizona, Tucson.
Christian BimeDepartment of Medicine, University of Arizona, Tucson; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Arizona, Tucson; Arizona Respiratory Center, University of Arizona, Tucson.
Sairam ParthasarathyDepartment of Medicine, University of Arizona, Tucson; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Arizona, Tucson; Arizona Respiratory Center, University of Arizona, Tucson. Electronic address: spartha@arc.arizona.edu.
University of Arizona · USArizona Science Center · US

Funding

Chronic Moderate Sleep Restriction in Older Long and Older Average SleepersR01HL095799 · NHLBI · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI IRWIN, MICHAEL R, JEAN-LOUIS, GIRARDIN · 2011 to 2015
$3.8M
Sleep Intervention During Acute Lung InjuryR01HL095748 · NHLBI · UNIVERSITY OF ARIZONA · PI PARTHASARATHY, SAIRAM · 2009 to 2013
$1.9M
(PQA 2) Obesity & Obstructive Sleep Apnea in Hepatocellular Carcinoma ProgressionR21CA184920 · NCI · UNIVERSITY OF ARIZONA · PI MARTINEZ, JESSE D. · 2014 to 2015
$362k
NCI NIH HHS CA184920NCI NIH HHS R21 CA184920NHLBI NIH HHS 5R01HL095748NHLBI NIH HHS HL095748NHLBI NIH HHS HL095799NHLBI NIH HHS R01 HL095748NHLBI NIH HHS R01 HL095799
6 · The paper itself

Abstract

backgroundSleep quality and quantity are severely reduced in critically ill patients receiving mechanical ventilation with a potential for adverse consequences. Our objective was to synthesize the randomized controlled trials (RCTs) that measured the efficacy of sleep-promoting interventions on sleep quality and quantity in critically ill patients.

methodsWe included RCTs that objectively measured sleep with electroencephalography or its derivatives and excluded observational studies and those that measured sleep by subjective reports. The research was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

resultsOf 6022 studies identified, 13 met eligibility criteria involving 296 critically ill patients. Eight trials looked at different modes of mechanical ventilation as sleep interventions, and the remaining 5 involved pharmacologic, nonpharmacologic, or environmental interventions. Meta-analysis of the studies revealed that sleep-promoting interventions improved sleep quantity (pooled standardized mean difference [SMD], 0.37; 95% confidence interval [CI], 0.05-0.69; P = .02) and sleep quality through reduction in sleep fragmentation (SMD, -0.31; 95% CI, -0.60 to -0.01; P = .04). Subgroup analysis revealed that timed modes of ventilation improved sleep quantity when compared with spontaneous modes of ventilation (SMD, 0.45; 95% CI, 0.10-0.81; P = .01). Nonmechanical ventilation interventions tended to improve sleep quantity (SMD, 0.65; 95% CI, -0.03 to 1.33; P = .06) and to reduce sleep fragmentation (SMD, -0.29; 95% CI, -0.61 to 0.03; P = .07).

conclusionsThe synthesized evidence suggests that both mechanical ventilation- and nonmechanical ventilation-based therapies improve sleep quantity and quality in critically ill patients, but the clinical significance is unclear. In the future, adequately powered multicenter RCTs involving pharmacologic interventions to promote sleep in critically ill patients are warranted.

Indexed as

Critical CareCritical IllnessElectroencephalographyHumansRespiration, ArtificialSleepSleep DeprivationTreatment OutcomeArtificial respirationCritical careCritical illnessHypnotics and sedativesPolysomnographyPositive-pressure respirationSleep

Identifiers

PMID26071825
PMCPMC4577445
OpenAlexW1698070256

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.