Respiratory sleep disorders in the intensive care unit.

The study of respiratory sleep disorders in intensive care is a developing field. Indeed sleep pathology concerns not only pneumologists and neurophys iologists but also numerous specialties including medicosurgical resuscitat ion. The advent of "portable" appliances should facilitate access to polyso mnography (PSG) for diagnosis of sleep respiratory disorders (RDS) in the i ntensive care unit. This examination can be appropriate in two separate cir cumstances. RDS in life-threatening situations (generally respiratory and/o r cardiac failure) or when RDS is worsened by the specific conditions of in tensive care units: "intensive care-induced RDS". In both cases, easy diagn osis of RDS by PSG allows adjustment of the treatment (corrections of iatro genic factors, continuous positive airway pressure [CPAP], noninvasive vent ilation [NIV], oxygen [O-2]. A specific treatment of the well documented RD S is most desirable, as the patients are considered to be at high risk for endotracheal intubation. If diagnosis of RDS is not made during the acute p hase, the intensive care physician should be informed of the clinical and p araclinical elements leading to prescription of a delayed polysomnography i n order to reduce the risk of further vital distress.