ReviewFrontiers in neurology2020
Abnormal Sleep, Circadian Rhythm Disruption, and Delirium in the ICU: Are They Related?
Review in Frontiers in neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Effects of non-pharmacological interventions on sleep in patients with critical illness: a systematic review and network meta-analysis.Scientific reports · 2026Pooled it
- Flexible family visitation and postoperative delirium in an orthopedic intensive care unit: A randomized trial examining surgical-type heterogeneity and cost outcomes.The Journal of international medical research · 2026Trial
- Effect of the orexin receptor antagonist, suvorexant, on sleep architecture in the early postoperative period following cardiac surgery: a randomized controlled trial.Critical care (London, England) · 2026Trial
- Protocol for a feasibility randomised controlled trial of administering daytime only enteral feeding compared to standard continuous enteral feeding, to reduce delirium in mechanically ventilated, critically ill adults, with qualitative and circadian mechanistic sub-studies.Journal of the Intensive Care Society · 2026Article
- Effects of a non-pharmacological multicomponent intervention on delirium, sleep quality, and total sleep time among emergency intensive care unit patients in South Korea: a non-equivalent control group time-series study.Journal of Korean biological nursing science · 2026Article
- Potentials and challenges of an integrative medicine protocol in intensive care: the perspective of intensive care nurses.BMC complementary medicine and therapies · 2026Article
- Clinical Care Interaction and Patient Sleep in the Intensive Care Unit: A Secondary Data Analysis.Nursing in critical care · 2026Article
- Quantifying sleep wake rhythms in the hospital environment with digital technologies.NPJ digital medicine · 2026Article
- Postoperative Delirium After Cardiac Surgery: Psychiatric Vulnerability, Biological Mechanisms, and Prevention Strategies.Medical sciences (Basel, Switzerland) · 2026Review
- Neurological Complications in Intensive Care Units: From Delirium to Long-Term Cognitive Dysfunction-A Narrative Review.Journal of clinical medicine · 2026Review
- Sleep Quality and Delirium Occurrence in Intensive Care Unit Patients: A Prospective Observational Study.Nursing in critical care · 2026Observational
- A pilot, parallel-group, blinded, placebo-controlled, randomiseCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Knowledge, Attitudes, and Self‑Reported Practices Regarding Sleep‑Focused Delirium Prevention Among ICU Professionals: A Multicenter Survey in Jiangxi, China.Nature and science of sleep · 2026Article
- Hype or hope? The potential of melatonin for delirium prevention in the intensive care unit.Critical care science · 2026Article
- Barriers to hand hygiene practices and improvement expectations among awake ICU patients: a qualitative study.Frontiers in public health · 2026Article
- Noise in the Intensive Care Unit: A Narrative Review of Its Characteristics, Clinical Impact, and Reduction Strategies.Critical care research and practice · 2026Review
- Quantifying Sleep-Wake Rhythms in the Hospital Environment with Digital Technologies.medRxiv : the preprint server for health sciences · 2025Article
- Critically ill patients with a reverse blood pressure dipping phenotype at increased risk for delirium and death.Scientific reports · 2025Article
- Sleep Quality Assessment in Intensive Care Units: Comparing Actigraphy and the Richards Campbell Sleep Questionnaire-A Pilot Study in the Moroccan Context.Clocks & sleep · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Delirium is a syndrome characterized by acute brain failure resulting in neurocognitive disturbances affecting attention, awareness, and cognition. It is highly prevalent among critically ill patients and is associated with increased morbidity and mortality. A core domain of delirium is represented by behavioral disturbances in sleep-wake cycle probably related to circadian rhythm disruption. The relationship between sleep, circadian rhythm and intensive care unit (ICU)-acquired delirium is complex and likely bidirectional. In this review, we explore the proposed pathophysiological mechanisms of sleep disruption and circadian dysrhythmia as possible contributing factors in transitioning to delirium in the ICU and highlight some of the most relevant caveats for understanding the relationship between these complex phenomena. Specifically, we will (1) review the physiological consequences of poor sleep quality and efficiency; (2) explore how the neural substrate underlying the circadian clock functions may be disrupted in delirium; (3) discuss the role of sedative drugs as contributors to delirium and chrono-disruption; and, (4) describe the association between abnormal sleep-pathological wakefulness, circadian dysrhythmia, delirium and critical illness. Opportunities to improve sleep and readjust circadian rhythmicity to realign the circadian clock may exist as therapeutic targets in both the prevention and treatment of delirium in the ICU. Further research is required to better define these conditions and understand the underlying physiologic relationship to develop effective prevention and therapeutic strategies.
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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.