A prospective observational study has confirmed that sleep disturbances are common in survivors of severe pulmonary ARDS, both before and weeks after ICU discharge. Despite some improvement over time, sleep quality remained impaired in many patients.
The study aimed to assess sleep quality in patients who survived invasive ventilation for acute respiratory distress syndrome (ARDS). It included eligible non-COVID-19 patients diagnosed with severe pulmonary ARDS. Sleep evaluation was done before hospital discharge and again at six weeks post-discharge using the Epworth Sleepiness Scale (ESS), Richards–Campbell Sleep Questionnaire (RCSQ), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and overnight level 1 polysomnography (PSG).
Out of 54 ARDS survivors, 23 were included. Scrub typhus was the most common cause. The mean PaO2/FiO2 ratio was 110.90 ± 21.6, and the mean APACHE-II score was 19.04 ± 5.1. ICU stay averaged 14.22 ± 10.5 days. Changes in mean ESS and RCSQ scores from discharge to six weeks were statistically significant (p < 0.001). At discharge, sleep efficiency was low (61.6 ± 7.2%), mainly in N1 and N2 stages. This improved by six weeks (68.52 ± 7.8%, p < 0.001). The REM sleep component also increased from 10.96 ± 2.83 to 15.31 ± 9.96 (p < 0.001). Seven patients had apnea-hypopnea index (AHI) >5 initially, reduced to four at follow-up. The oxygen desaturation index showed significant improvement. Thirteen patients had PSQI >5 at six weeks. PaO2/FiO2 ratio correlated positively with RCSQ scores, while the duration of mechanical ventilation showed a positive correlation with PSQI and ISI scores (p < 0.001 for all).
The findings indicate that ARDS survivors frequently experience persistent sleep disturbances post-ICU, even after six weeks. Though some sleep parameters improve with time, many patients continue to show poor sleep quality, emphasizing the need for post-discharge follow-up and intervention.
