TY - JOUR
T1 - Post-discharge insomnia symptoms are associated with quality of life impairment among survivors of acute lung injury
AU - Parsons, Elizabeth C.
AU - Kross, Erin K.
AU - Caldwell, Ellen S.
AU - Kapur, Vishesh K.
AU - McCurry, Susan M.
AU - Vitiello, Michael V.
AU - Hough, Catherine L.
N1 - Funding Information:
This work was supported by the National Institutes of Health [Grants HL007287-31 , K23HL74294 ]. Dr. Parsons is supported by a Veterans Affairs Health Services Research and Development Fellowship [TPM 61-037]. The views expressed are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.
PY - 2012/9
Y1 - 2012/9
N2 - 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.
AB - 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.
KW - Adult/therapy
KW - Insomnia
KW - Intensive care units
KW - Quality of life
KW - Respiratory distress syndrome
KW - Sleep initiation and maintenance disorders
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U2 - 10.1016/j.sleep.2012.05.010
DO - 10.1016/j.sleep.2012.05.010
M3 - Article
C2 - 22763017
AN - SCOPUS:84865304687
SN - 1389-9457
VL - 13
SP - 1106
EP - 1109
JO - Sleep Medicine
JF - Sleep Medicine
IS - 8
ER -