Grant: Fellowship - PA - Sleep and Circadian Rhythms (Clinician)

Very sick patients connected to breathing machines have a high mortality and those who survive experience psychological and functional disabilities. These problems might be related to modifiable factors such as sleep disruption and uncomfortable interactions between the patients and breathing machines ("asynchronies"). Previous research proved that "asynchronies" are related to sleep problems in these patients, but what is the exact relation between these factors remains unknown. Adequately evaluating sleep in patients connected to breathing machines was not possible until the recent invention of a new scoring system named Odds Ratio Product (ORP), a numerical scale that ranges from 0 to 2.5. We used ORP in a previous study for the first time in this type of patients and showed that is a useful tool to measure sleep problems in patients connected to breathing machines. I hypothesize that sleep problems measured with ORP will be intimately related with the presence of "asynchronies" and sleep problems measured with ORP will be more frequent in patients with "asynchronies". I will enroll patients with breathing failure connected to breathing machines and measure sleep using ORP and "asynchronies". I will then correlate the two variables trying to understand the relationship between the two. This project will prove what the exact relationship between sleep problems and "asyncrhonies" is and help to design a strategy to modify the settings of the breathing machines to avoid "asynchronies" and improve sleep in very sick patients preventing future psychological and functional disabilities.