Critical Care Time 67. Sleeping in the ICU: Why is it critical and how do we help our patients get more of it?
Jan 26, 2026
A lively dive into why sleep is vital for ICU patients and how biology like the glymphatic system and circadian cues matter. They outline how ICU care fragments REM and deep sleep and list common disruptors such as light, noise, meds, and care activities. Practical fixes are explored, from clustering care and adjusting ventilator settings to timed light, temperature, feeding, and cautious use of melatonin or dexmedetomidine.
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Sleep Is An Evolutionary Necessity
- Sleep is universal across vertebrates, implying a vital conserved function.
- Evolution preserved sleep despite wide variation in duration and form.
Sleep Clears Brain Waste
- Sleep may restore the brain by increasing interstitial space and CSF flow to clear metabolites.
- This glymphatic activity appears especially active during non-REM deep sleep.
Sleep Consolidates Memory And Mood
- Sleep supports memory consolidation: NREM favors declarative memory and REM favors procedural memory.
- Sleep also downregulates amygdala hyperactivity and stabilizes mood.