Nav: Home

Intensive care quality of sleep improved by new drug, reports study

December 12, 2007

A new sedative drug has been shown to improve the sleep quality and comfort levels of intensive care patients, compared to the most commonly-used medication, according to research published today in the journal JAMA.

US and UK researchers compared the effects of the new drug dexmedetomidine with the commonly used sedative lorazepam, both of which reduce the pain and anxiety experienced by mechanically ventilated ICU patients and which help them to tolerate invasive procedures such as the insertion of catheters and feeding tubes.

While the routinely-administered lorazepam successfully lessens discomfort, it has also been associated with an increased risk of brain dysfunction, including coma and delirium, which prolong patients' time in hospital and raise the chance of death.

Now trials led by researchers at Vanderbilt University Schools of Medicine and Nursing in the US have shown that dexmedetomidine can provide better sedation and analgesia whilst at the same time reducing instances of coma and delirium.

The double-blind randomised controlled trials administered either dexmedetomidine or lorazepam for up to 120 hours to 106 volunteer adult mechanically ventilated ICU patients.

They found that around 30 per cent fewer patients in the dexmedetomidine group experienced coma, and that this group also experienced an average of four more coma-free and delirium-free days over study days one to 12 than those using lorazepam.

At the same time, dexmedetomidine proved to be a more effective sedative, with 80 per cent of the dexmedetomidine group sedated to the target level over the course of the trial, compared with 67% of the lorazepam group.

The study, carried out by researchers at Vanderbilt University, Tennessee, builds on the pioneering work of Professor Mervyn Maze of Imperial College London, who discovered and patented the sedative and hypnotic properties of dexmedetomidine in 1986, whilst he was at Stanford University.

"This study is a very big step forward," said Professor Maze. "Though it was not a large study in terms of number of patients, it conclusively shows that some sedative drugs have a more beneficial effect on sleep pathways than others."

Doctors estimate that an intensive care patient under sedation typically gets about two hours sleep out of every 24 hours. Professor Maze adds:

"Good quality sleep, both coma-free and delirium-free, is critical for a patient in intensive care, as we know this can improve their chances of beating off further illness and infection, and ultimately their survival. The study shows that dexmedetomidine could be very good news for those very sick patients in ICU.

"After 20 years of studying it, and understanding its mechanism of action and successfully predicting the application, it's wonderful to have a demonstration of how the molecule actually improves the patient's quality of life. It's a great example of how translational medical research brings benefit to patients."

After uncovering the molecular mechanism for its sedative effect in rodents, Professor Maze collaborated with Professor Nick Franks, also of Imperial College London, to understand how alpha-2 agonist drugs such as dexmedetomidine differ from benzodiazepine drugs such as lorazepam through studies of human volunteers.

The researchers hope that future studies measuring the quality of sleep experienced by ICU patients using different types of sedative will provide a greater understanding of the effects of the different drugs on brain dysfunction.
-end-


Imperial College London

Related Sleep Articles:

Baby sleeping in same room associated with less sleep, unsafe sleep habits
The American Academy of Pediatrics (AAP) recommends parents keep babies in the same room with them to sleep for the first year to prevent sudden infant death syndrome (SIDS).
Alternating skimpy sleep with sleep marathons hurts attention, creativity in young adults
Skimping on sleep, followed by 'catch-up' days with long snoozes, is tied to worse cognition -- both in attention and creativity -- in young adults, in particular those tackling major projects, Baylor University researchers have found.
Sleep trackers can prompt sleep problems
A researcher and clinician in the sleep disorders program in the Department of Behavioral Sciences at Rush University Medical Center and an associate professor at Rush University, Baron says use of these devices follows a pattern reflected in the title of the Sleep Medicine study: 'Orthosomnia: Are Some Patients Taking the Quantified Self Too Far?'
UW sleep research high-resolution images show how the brain resets during sleep
Striking electron microscope pictures from inside the brains of mice suggest what happens in our own brain every day: Our synapses -- the junctions between nerve cells -- grow strong and large during the stimulation of daytime, then shrink by nearly 20 percent while we sleep, creating room for more growth and learning the next day.
What is good quality sleep? National Sleep Foundation provides guidance
The National Sleep Foundation (NSF) recently released the key indicators of good sleep quality, as established by a panel of experts.
More Sleep News and Sleep Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Teaching For Better Humans
More than test scores or good grades — what do kids need to prepare them for the future? This hour, guest host Manoush Zomorodi and TED speakers explore how to help children grow into better humans, in and out of the classroom. Guests include educators Olympia Della Flora and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...