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Sleep quality and excessive daytime sleepiness in patients treated in the Intensive Care Unit for acute myocardial infarction


As constant surveillance, monitoring and assistance are needed, lighting inside intensive care units (ICU) affects patient’s circadian rhythm, which may compromise sleep quality. Given the impact of poor sleep quality on the clinical condition of critical patients, sleep importance and melatonin synthesis by the pineal gland for maintenance of the homeostasis in the cardiovascular system, it is vital to know and explore all sleep pattern aspects of patients hit by acute myocardial infarction (AMI).


Identify perception of sleep quality and daytime sleepiness in patients hospitalized for AMI at ICU and describe the site’s lighting level.


Descriptive study conducted at a cardiac ICU of a university hospital based in São Paulo, Brazil. The sample was comprised of 18+ year-old patients, following a primary AMI event with or without ST segment elevation, minimum score of 14 points in the Glasgow Coma Scale, minimum stay time of 12 hours, without cognitive deficit and with spontaneous ventilation or using non-invasive ventilation support. Sociodemographic data, Sleep Assessment in Cardiac Intensive Therapy Questionnaire, Stanford Sleepiness Scale (SSS) and related to lighting levels in lux of the site, with a digital lux meter, was collected.


Eight patients were included, with median age of 55 years, being 87.5% male, all were hypertensive, 50% diabetic and 50% smokers. Were mostly hit by AMI with ST segment elevation (87.5%) and being classified as Killip I (75%). The sleep assessment questionnaire had mean score of 67.25±9.79 points, being 62.5% of patients classified as having good quality sleep and 37.5% regular sleep. According to the SSS 42.9% of patients felt active, aware and alert. Sleep interruption was referred by 87.5% of patients, being 85.7% the health team. The site’s lighting was noted by 25% of patients as the factor that interfered a lot in the sleep quality. The lighting mean during the nocturnal period was 16.18±11.29 lux, with lower levels from 12:00 am to 03:00 am.


Sleep quality of patients assessed ranged from good to regular without experiencing daytime sleepiness and the site’s lighting during the nocturnal period remained low. Nonetheless, it has been evidenced that factors related to care and environment, such as nocturnal lighting and sleep interruptions by the health team compromised the sleep pattern or constituted a stressing factor for the sleep.


Sleep quality, daytime sleepiness, nursing, acute myocardial infarction, lighting.


Área Clínica


Universidade Federal de São Paulo - São Paulo - Brasil


Karina Thalita da Silva Higa, Fernanda Aparecida Ferraro Böhme, Simone Paschoa, Ana Cláudia Rodrigues Conte, Vinícius Batista Santos, Ariane Ferreira Machado Avelar