Evidence map›Paper›PMID 39355496›Full record

ArticleCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine2024

A multicentre point prevalence study of nocturnal hours awake and enteral pharmacological sleep aids in patients admitted to Australian and New Zealand intensive care units.

Laurie Showler, Adam M Deane, Edward Litton, Melissa J Ankravs, Bradley Wibrow, Deborah Barge, Jeremy Goldin, Naomi Hammond, Manoj K Saxena, Paul J Young and 3 more

Abstract read
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In one paragraph

Article in Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Interpreting sleep outcomes in the ICU: Reflections on the DREAM trial-Author's reply.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026
    Article
  2. A pilot, parallel-group, blinded, placebo-controlled, randomiseCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026
    Article
  3. Review
  4. Article
  5. Sleep in the ICU - A complex challenge requiring multifactorial solutions.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025
    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

13 authors.

Laurie ShowlerDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Adam M DeaneDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Edward LittonUniversity of Western Australia, Perth, Western Australia, Australia.
Melissa J AnkravsDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Bradley WibrowUniversity of Western Australia, Perth, Western Australia, Australia.
Deborah BargeDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Jeremy GoldinDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Naomi HammondMalcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Manoj K SaxenaCritical Care Program, The George Institute for Global Health, UNSW Sydney, Barangaroo, New South Wales, Australia.
Paul J YoungCritical Care Program, The George Institute for Global Health, UNSW Sydney, Barangaroo, New South Wales, Australia.
Bala VenkateshCritical Care Program, The George Institute for Global Health, UNSW Sydney, Barangaroo, New South Wales, Australia.
Mark FinnisDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Yasmine Ali AbdelhamidDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Critically ill patients suffer disrupted sleep. Hypnotic medications may improve sleep; however, local epidemiological data regarding the amount of nocturnal time awake and the use of such medications is needed. Design: Point prevalence study. Setting: Adult ICUs in Australia and New Zealand. Participants: All adult patients admitted to participating Intensive Care Units (ICUs) on the study day. Main outcome measures: Time awake overnight (22:00-06:00) was determined by structured nurse observation. The use of enterally administered sedative-hypnotic drugs prior to and during ICU admission was recorded, as was the use of a unit policy and non-pharmacological sleep promotion strategies. Results: Data were available for 532 patients admitted to 40 ICUs (median age 60 years, 336 (63.2%) male, and 222 (41.7%) invasively ventilated). Forty-eight patients (9.0%) received an enteral pharmacological sleep aid, of which melatonin (28, 5.2%) was most frequently used. Patients not invasively ventilated were observed to be awake overnight for a median of 4.0 h (interquartile range (IQR): 2.5, 5.5), with no difference in those receiving an enteral hypnotic (p = 0.9). Non-pharmacological sleep aids were reportedly not offered or available for 52% (earplugs) and 63% of patients (eye masks). Only 7 (17.5%) participating ICUs had a policy informing sleep-optimising interventions. Conclusions: Patients not receiving invasive ventilation appeared to spend many nocturnal hours awake. Pharmacological sleep aid administration was not associated with a greater observed time asleep. Most patients did not receive any non-pharmacological aid, and most ICUs did not have a local guideline or unit policy on sleep promotion.

Indexed as

Critical illnessHypnotics and sedativesMelatoninSleepSleep-wake disorders

Identifiers

PMID39355496
PMCPMC11440063

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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.