Internal Medicine · 2 h ago
Intravenous GHB was associated with deeper sleep in 13 awake ICU patients
In a small, uncontrolled polysomnographic study, 13 non-sedated ICU patients underwent overnight sleep monitoring; eight received intravenous gamma-hydroxybutyrate (GHB). GHB use was associated with higher sleep efficiency and more N3 sleep, but also less REM sleep and increased morning sodium levels.
- Eight of 13 patients received nocturnal intravenous GHB.
- Sleep efficiency and N3 sleep were higher with GHB.
- REM sleep was reduced; morning sodium was higher.
- Small, uncontrolled findings do not support routine use.
Researchers report a one-night polysomnographic experience in 13 calm, awake, non-delirious patients in a general ICU; none was invasively ventilated. Eight received nocturnal intravenous GHB at the attending physician’s discretion, while five did not. The study compared sleep architecture, patient-rated sleep quality, and observed safety measures. Because treatment was not randomized and recordings before treatment were unavailable, the groups may not be directly comparable.
Median sleep efficiency was 82% with GHB versus 57% without it, and N3 sleep accounted for 58% versus 8% of total sleep time. REM sleep was lower with GHB (5% vs. 13%) and absent in two treated patients. All eight GHB recipients were considered to have slept by nurses, compared with two of five untreated patients. Morning sodium was 140 versus 135 mmol/L. No bradycardia, hypotension, desaturation, vomiting, or seizure was reported; three treated patients had repeated arousals from slow-wave sleep, and one became agitated.
The findings suggest an association with longer, deeper, and better-perceived sleep, but do not establish clinical benefit or safety. Standard polysomnography may not distinguish natural slow-wave sleep from drug-induced delta activity, and the effect of reduced REM sleep is uncertain. The authors call for controlled trials before routine use; a placebo-controlled trial is planned.
In practice
For awake, non-delirious ICU patients who are not invasively ventilated, this small uncontrolled experience found that nocturnal intravenous GHB was associated with greater sleep efficiency and N3 sleep, but also reduced REM sleep and higher morning sodium. These findings do not establish restorative sleep, clinical benefit, or safety, and confounding by treatment selection is possible. Drug-related delta activity may resemble slow-wave sleep on polysomnography. The authors state that controlled-trial confirmation is needed before routine use.
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Critical Care: Nocturnal intravenous gamma-hydroxybutyrate and sleep architecture in non-sedated intensive care unit patients: a polysomnographic experience ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.