Abstract：
CONCLUSIONS: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
OBJECTIVE: To review causes, risk factors, and consequences of sleep disruption in critically ill patients; evaluate the role of nonpharmacological and pharmacological therapies for management of sleep in the intensive care unit (ICU); and discuss the role of pharmacists in implementation of sleep bundles.
CONCLUSIONS: Critically ill patients often have disrupted sleep and circadian rhythm alterations that cause anxiety, stress, and traumatic memories. This can be caused by factors such as critical illness, environmental factors, mechanical ventilation, and medications. Methods to evaluate sleep, including polysomnography and questionnaires, have limitations that should be considered. Multicomponent sleep bundles with a focus on nonpharmacological therapy aiming to reduce nocturnal noise, light, and unnecessary patient care may improve sleep disorders in critically ill patients. While pharmacological agents are often used to facilitate sleep in critically ill patients, evidence supporting their use is often of low quality, which limits use to patients who have sleep disruption refractory to nonpharmacological therapy. Dedicated interprofessional teams are needed for implementation of sleep bundles in the ICU. Extensive pharmacotherapeutic training and participation in daily patient care rounds make pharmacists vital members of the team who can help with all components of the bundle. This narrative review discusses evidence for elements of the multicomponent sleep bundle and provides guidance on how pharmacists can help with implementation of nonpharmacological therapies and management of neuroactive medications to facilitate sleep.
CONCLUSIONS: Sleep bundles are necessary for patients in the ICU, and dedicated interprofessional teams that include pharmacists are vital for their successful creation and implementation.
OBJECTIVE: To review causes, risk factors, and consequences of sleep disruption in critically ill patients; evaluate the role of nonpharmacological and pharmacological therapies for management of sleep in the intensive care unit (ICU); and discuss the role of pharmacists in implementation of sleep bundles.
CONCLUSIONS: Critically ill patients often have disrupted sleep and circadian rhythm alterations that cause anxiety, stress, and traumatic memories. This can be caused by factors such as critical illness, environmental factors, mechanical ventilation, and medications. Methods to evaluate sleep, including polysomnography and questionnaires, have limitations that should be considered. Multicomponent sleep bundles with a focus on nonpharmacological therapy aiming to reduce nocturnal noise, light, and unnecessary patient care may improve sleep disorders in critically ill patients. While pharmacological agents are often used to facilitate sleep in critically ill patients, evidence supporting their use is often of low quality, which limits use to patients who have sleep disruption refractory to nonpharmacological therapy. Dedicated interprofessional teams are needed for implementation of sleep bundles in the ICU. Extensive pharmacotherapeutic training and participation in daily patient care rounds make pharmacists vital members of the team who can help with all components of the bundle. This narrative review discusses evidence for elements of the multicomponent sleep bundle and provides guidance on how pharmacists can help with implementation of nonpharmacological therapies and management of neuroactive medications to facilitate sleep.
CONCLUSIONS: Sleep bundles are necessary for patients in the ICU, and dedicated interprofessional teams that include pharmacists are vital for their successful creation and implementation.
摘要：
结论：为了加快文章的发表，AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑，但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本，将在以后替换为最终文章（按照AJHP样式格式化并由作者证明）。
目标：回顾原因，危险因素，和危重患者睡眠中断的后果;评估非药物和药物疗法在重症监护病房（ICU）睡眠管理中的作用;并讨论药剂师在实施睡眠捆绑中的作用。
结论：重症患者的睡眠和昼夜节律改变常引起焦虑，压力，和创伤记忆。这可能是由危重疾病等因素引起的，环境因素,机械通气,和药物。评估睡眠的方法，包括多导睡眠图和问卷调查,有应该考虑的局限性。多组分睡眠束，专注于非药物治疗，旨在减少夜间噪音，光,不必要的病人护理可以改善危重病人的睡眠障碍。虽然药物通常用于促进危重病人的睡眠，支持其使用的证据通常质量低，这限制了非药物治疗难以治疗的睡眠中断患者的使用。需要专门的跨专业团队来在ICU中实施睡眠捆绑。广泛的药物治疗培训和参与日常患者护理回合使药剂师成为团队的重要成员，他们可以帮助捆绑的所有组成部分。这篇叙述性综述讨论了多组分睡眠束元素的证据，并提供了有关药剂师如何帮助实施非药物疗法和管理神经活性药物以促进睡眠的指导。
结论：对于ICU患者来说，睡眠捆绑是必要的，包括药剂师在内的专业团队对于他们的成功创建和实施至关重要。
目标：回顾原因，危险因素，和危重患者睡眠中断的后果;评估非药物和药物疗法在重症监护病房（ICU）睡眠管理中的作用;并讨论药剂师在实施睡眠捆绑中的作用。
结论：重症患者的睡眠和昼夜节律改变常引起焦虑，压力，和创伤记忆。这可能是由危重疾病等因素引起的，环境因素,机械通气,和药物。评估睡眠的方法，包括多导睡眠图和问卷调查,有应该考虑的局限性。多组分睡眠束，专注于非药物治疗，旨在减少夜间噪音，光,不必要的病人护理可以改善危重病人的睡眠障碍。虽然药物通常用于促进危重病人的睡眠，支持其使用的证据通常质量低，这限制了非药物治疗难以治疗的睡眠中断患者的使用。需要专门的跨专业团队来在ICU中实施睡眠捆绑。广泛的药物治疗培训和参与日常患者护理回合使药剂师成为团队的重要成员，他们可以帮助捆绑的所有组成部分。这篇叙述性综述讨论了多组分睡眠束元素的证据，并提供了有关药剂师如何帮助实施非药物疗法和管理神经活性药物以促进睡眠的指导。
结论：对于ICU患者来说，睡眠捆绑是必要的，包括药剂师在内的专业团队对于他们的成功创建和实施至关重要。
