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Post-discharge insomnia symptoms are associated with quality of life impairment among survivors of acute lung injury.

Abstract

INTRODUCTION
Sleep disturbance is common during critical illness, yet little is known about its prevalence or role in post-discharge quality of life among high-risk acute lung injury (ALI) patients.
METHODS
In a prospective cohort of 61 mechanically ventilated ALI patients, we examined the association between insomnia symptoms and quality of life six months after discharge. Subjects completed surveys rating quality of life (MOS SF-36), post-traumatic stress disorder (PCL), and depression (PHQ-9). Using an individual item from the PCL, we defined insomnia symptoms as moderate or greater trouble falling or staying asleep in the past month. We performed multivariable linear regression to examine the association between insomnia symptoms and SF-36 physical and mental component summary scores, adjusting for PTSD and depression.
RESULTS
Forty subjects (85% of eligible) completed six-month questionnaires; 20 (50%) met criteria for insomnia symptoms. After adjustment for PTSD and depression, insomnia symptoms remained significantly associated with worse physical component summary scores (adjusted mean difference=-8.8; 95% CI: -15.0, -2.5; P<0.01).
CONCLUSIONS
Post-discharge insomnia symptoms were common and significantly associated with physical quality of life impairment among six-month ALI survivors, even after adjustment for PTSD and depression symptoms. Further studies are needed to validate these results and to characterize sleep disturbance after ALI using sleep-specific metrics.

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  • Publisher Full Text

    • Authors

    Parsons EC, Kross EK, Caldwell ES, Kapur VK, McCurry SM, Vitiello MV, Hough CL

    Institution

    Health Services Research and Development Northwest Center of Excellence, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA 98101, United States. parsonse@u.washington.edu

    Source

    Sleep medicine 13:8 2012 Sep pg 1106-9

    MeSH

    APACHE
    Acute Lung Injury
    Adult
    Female
    Health Surveys
    Humans
    Intensive Care
    Male
    Patient Discharge
    Prevalence
    Prospective Studies
    Quality of Life
    Questionnaires
    Risk Factors
    Sleep Initiation and Maintenance Disorders
    Survivors
    Wounds and Injuries

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

    Language

    eng

    PubMed ID

    22763017