ÖZET
Giriş:
Yoğun bakım ünitesine (YBÜ) kabul edilen hastalarda uyku bozukluğu yaygındır ve çeşitli olumsuz etkilerle ilişkilidir. Bu çalışmada, çok bileşenli bir uyku protokolünün uygulanmasının hem sübjektif (bir anket ile değerlendirilen) hem de objektif olarak (aktigrafi kullanılarak ölçülen) uyku kalitesini iyileştirip iyileştirmediğinin araştırılması amaçlandı.
Gereç ve Yöntem:
İleri dönük girişimsel, randomize olmayan kontrollü bir çalışmada, 20 spontan bilinci açık YBÜ hastasından oluşan iki grup (PRE ve POST gruplar) karşılaştırıldı.
Bulgular:
Subjektif olarak değerlendirilen uyku kalitesi tüm örneklemde zayıftı (n=40) [Richards-Campbell Uyku Anketi (RCSQ) toplam 49,2±25,1]. Ortalama toplam uyku süresi 389,0±78,8 dk, Uyku Etkinlik indeksi (SEI) %81,1±16,4 ve gece uyanma sayısı 18,4±9,79 idi. Uyku kalitesi (hem sübjektif hem de objektif), incelenen parametrelerin çoğundan anlaşıldığı gibi, uyku protokolünün (POST grubu) uygulanmasının ardından önemli ölçüde düzelmedi. Subjektif değerlendirme daha iyi sonuçlar verdi (RCSQ toplamı: PRE‘de 45,1’ye karşılık POST’de 51,1); ancak istatistiksel olarak anlamlı değillerdi. Paradoksal olarak, kontrol grubunda SEI (PRE’de %86,6’ya karşılık POST’de %75,9, p=0,044), toplam uyku süresi (PRE’de 416 dk’ya karşılık POST’de 364 dk, p=0,044) ve gürültü (T=2,11, p=0,046) için istatistiksel olarak anlamlı derecede daha iyi sonuçlar gözlendi.
Sonuç:
Sonuçlar çok bileşenli protokolün önemli bir etki ortaya koymadığını doğrulamakta başarısız olsa da, klinik pratikte uygulanması değerli olabilir. Seçilmiş bir YBÜ hastası grubunda, önerilen müdahaleler iyi bir uykuya ulaşmaya ve genel konforlarını iyileştirmeye yardımcı olabilir.
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