ArticleThe Journal of international medical research2021
Sleep and circadian rhythm disturbances in intensive care unit (ICU)-acquired delirium: a case-control study.
Article in The Journal of international medical research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05713877 (DELIRE-ICU), which is not on this map. Cited by 21 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.
DELIRE-ICU: A Randomised Controlled Feasibility Trial of Melatonin vs Placebo in the Treatment of Delirium in the Intensive Care Unit
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Application of light in delirium: a bibliometric analysis.Frontiers in neurology · 2025Pooled it
- Sleep quality assessment in hospitalized postoperative surgical patients: a COSMIN-based systematic review.Frontiers in sleep · 2025Pooled 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
- Sleep interruption aggravates sepsis by rewiring the macrophage immune response.Journal of immunology (Baltimore, Md. : 1950) · 2026Article
- Evidence-Based Intervention for Sleep Deprivation in the Intensive Care Unit: A Clinical Review.Florence Nightingale journal of nursing · 2026Article
- Sleep Quality and Delirium Occurrence in Intensive Care Unit Patients: A Prospective Observational Study.Nursing in critical care · 2026Observational
- The Impact of Dynamic Lighting on Sleep Timing and Duration for Hospitalised Patients.Journal of sleep research · 2025Article
- The Association Between Frequency of Fingertip Blood Glucose Measurement and Delirium in Intensive Care Unit Patients: A Retrospective Study Based on the MIMIC-IV Database.Nursing in critical care · 2025Article
- Article
- Development and Validation of Machine Learning Models to Predict Postoperative Delirium Using Clinical Features and Polysomnography Variables.Journal of clinical medicine · 2024Article
- The Bispectral Electroencephalography Method Quantifies Postoperative Delirium-Like States in Young and Aged Male Mice After Head-Mount Implantation Surgery.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Effects of Chinese traditional five-element music intervention on postoperative delirium and sleep quality in elderly patients after non-cardiac surgery: a randomized controlled trial.Perioperative medicine (London, England) · 2024Article
- Mechanisms underlying delirium in patients with critical illness.Frontiers in aging neuroscience · 2024Review
- The influence of sleep disorders on perioperative neurocognitive disorders among the elderly: A narrative review.Ibrain · 2024Review
- Circadian rhythm disturbance and delirium in ICU patients: a prospective cohort study.BMC anesthesiology · 2023Article
- Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2023Article
- Sleep and critical illness: a review.Frontiers in medicine · 2023Review
- An Automated Algorithm for Determining Sleep Using Single-Channel Electroencephalography to Detect Delirium: A Prospective Observational Study in Intensive Care Units.Healthcare (Basel, Switzerland) · 2022Article
- E4BP4 Coordinates Circadian Control of Cognition in Delirium.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2022Article
- Feasibility and Acceptability of Using Wireless Limited Polysomnography to Capture Sleep Before, During, and After Hospitalization for Patients With Planned Cardiothoracic Surgery.The Journal of cardiovascular nursingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe relationships among sleep, circadian rhythm, and intensive care unit (ICU)-acquired delirium are complex and remain unclear. This study aimed to examine the pathophysiological mechanisms of sleep and circadian rhythm disturbances in patients with ICU-acquired delirium.
methodsThis study included critical adult patients aged 18 to 75 years who were treated in the ICU. Twenty-four-hour polysomnography was performed and serum melatonin and cortisol levels were measured six times during polysomnography. Receiver operating characteristic curves and binomial logistic regression were used to evaluate the potential of sleep, melatonin, and cortisol as indicators of delirium in the ICU.
resultsPatients with delirium (n = 24) showed less rapid eye movement (REM) sleep compared with patients without delirium (n = 24, controls). Melatonin levels were lower and cortisol levels were higher in the delirium group than in the control group. REM sleep, melatonin, and cortisol were significantly associated with delirium. The optimal cutoff values of REM sleep and mean melatonin and cortisol levels that predicted delirium were ≤1.05%, ≤422.09 pg/mL, and ≥212.14 ng/mL, respectively.
conclusionsREM sleep, and melatonin and cortisol levels are significantly associated with the risk of ICU-acquired delirium. Improved sleep and readjustment of circadian rhythmicity may be therapeutic targets of ICU-acquired delirium.
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Registered trials
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.