Journal Article Review Ahead of print
PubMed: 42285015 DOI: 10.1016/j.jcrc.2026.155649
Implementation and evaluation of the multidisciplinary "ABCDEF of sleep" protocol in Brazilian intensive care units: A quasi-experimental study. Results of a two-phase.
J Crit Care 95:155649
Authors: Laura Drehmer, Felippe Leopoldo Dexheimer Neto, Anielle Ferrazza, Tiago Fiabane Paviani, Andressa Dos Santos Gomes, Diogo Bolsson de Moraes Rocha, Henrique Mezzomo Pasqual, Pauline Eloise Mariani, Sarah Benedetti Custódio da Silva, Cleide Geittenes Albino, Mariana Fensterseifer Mattioni, Bruna Mirley Cavalcante Barreto Reinheimer, Isabel Cristina Feltes, Fabrícia Lúcia Loeblein Soares, Carlos Francisco Pereira do Bem, Bárbara Rayanne Fior, Felipe Cerbaro Viana, Laura Cordeiro Madeira, Cassiano Teixeira
Affiliations
- Unimed Vale dos Sinos Hospital, Vidal Brasil Streeet, 1671, Hamburgo Velho neighborhood, Novo Hamburgo, Rio Grande do Sul 93540-090, Brazil; Moinhos de Vento Hospital, Ramiro Barcelos Street, 910, Moinhos de Vento neighborhood, Porto Alegre, Rio Grande do Sul 90035-001, Brazil; Graduate Program in Pulmonary Sciences at the Federal University of Rio Grande do Sul. Ramiro Barcelos, 2400 - Santa Cecília neighborhood, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil.
- Moinhos de Vento Hospital, Ramiro Barcelos Street, 910, Moinhos de Vento neighborhood, Porto Alegre, Rio Grande do Sul 90035-001, Brazil.
- Moinhos de Vento Hospital, Ramiro Barcelos Street, 910, Moinhos de Vento neighborhood, Porto Alegre, Rio Grande do Sul 90035-001, Brazil.
- Unimed Vale dos Sinos Hospital, Vidal Brasil Streeet, 1671, Hamburgo Velho neighborhood, Novo Hamburgo, Rio Grande do Sul 93540-090, Brazil.
- Graduate Program in Pulmonary Sciences at the Federal University of Rio Grande do Sul. Ramiro Barcelos, 2400 - Santa Cecília neighborhood, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil.
Abstract
INTRODUCTION
Sleep disruption is common in intensive care units (ICUs) and is associated with adverse outcomes. We evaluated whether a multidisciplinary sleep protocol improves subjective sleep quality in critically ill patients.
METHODS
This multicenter quasi-experimental before-after study (2022-2024) was conducted in two Brazilian ICUs. Adult patients with an ICU stay of ≥2 nights were included. Sleep was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ) and the Sleep in the ICU Questionnaire (SICUQ). Following baseline assessment, structured training and a multifaceted "ABCDEF of Sleep" protocol were implemented. The primary outcome was the global RCSQ score; secondary outcomes included SICUQ domains and clinical outcomes.
RESULTS
A total of 112 patients were included (control = 61; intervention = 51). The primary outcome (aggregated 3-night RCSQ score) did not differ between groups (p = 0.31). In per-night analyses, RCSQ scores were higher on the second night in the intervention group (p = 0.008), with no differences on nights 1 or 3. The intervention improved perceived sleep quality and reduced environmental disturbances (p ≤ 0.001), without effects on mortality, mechanical ventilation, or length of stay. Family-reported sleep perception did not differ between groups.
CONCLUSIONS
A pragmatic sleep protocol improved subjective sleep quality and reduced environmental disturbances in ICU patients, but did not impact major clinical outcomes. Larger studies using objective measures are needed.
MeSH
Sleep, Critical Care, Intensive Care Units, Non-Randomized Controlled Trials As Topic