Scientific Investigations
Factors Affecting Sleep Quality of Patients in Intensive Care Unit
http://dx.doi.org/10.5664/jcsm.1920
Shailesh Bihari, M.D.1; R. Doug McEvoy, M.D.2,4; Elisha Matheson, B.Nurs.1; Susan Kim, Ph.D.3; Richard J. Woodman, Ph.D.3; Andrew D. Bersten, M.D.1
1Department of Intensive and Critical Care Medicine, Flinders Medical Centre, Bedford Park South Australia, Australia; 2Adelaide Institute for Sleep Health, Repatriation General Hospital, Daw Park, South Australia, Australia; 3Flinders Centre for Epidemiology and Biostatistics, Discipline of General Practice, Flinders University, South Australia, Australia; 4Flinders Centre for Clinical Change and Health Care Research, Flinders University, South Australia, Australia
Introduction:
Sleep disturbance is a frequently overlooked complication of intensive care unit (ICU) stay.
Aim:
To evaluate sleep quality among patients admitted to ICU and investigate environmental and non-environmental factors that affect sleep quality in ICU.
Methods:
Over a 22-month period, we consecutively recruited patients who spent ≥ 2 nights post-endotracheal extubation in ICU and who were orientated to time, place, and person on the day of discharge. Self-reported sleep quality, according to a modified Freedman questionnaire, which provided data on self-reported ICU sleep quality in ICU and environmental factors affecting sleep quality in the ICU, were collected. We also investigated non-environmental factors, such as severity of illness, ICU interventions, and medications that can affect sleep quality.
Results:
Fifty males and 50 females were recruited with a mean (± SD) age of 65.1 ± 15.2 years. APACHE II score at admission to ICU was 18.1 ± 7.5 with duration of stay 6.7 ± 6.5days. Self-reported sleep quality score at home (1 = worst; 10 = best) was 7.0 ± 2.2; this decreased to 4.0 ± 1.7 during their stay in ICU (p < 0.001). In multivariate analysis with APACHE III as severity of illness (R2 = 0.25), factors [exp(b)(95% CI), p value] which significantly affected sleep in ICU were sex [0.37(0.19-0.72), p < 0.01], age and sex interaction [1.02(1.01-1.03), p < 0.01], bedside phone [0.92(0.87-0.97), p < 0.01], prior quality of sleep at home [1.30(1.05-1.62), p = 0.02], and use of steroids [0.82(0.69-0.98), p = 0.03] during the stay in ICU.
Conclusion:
Reduced sleep quality is a common problem in ICU with a multifactorial etiology.
Citation:
Bihari S; McEvoy RD; Kim S; Woodman RJ; Bersten AD. Factors affecting sleep quality of patients in intensive care unit. J Clin Sleep Med 2012;8(3):301-307.
Please login to continue reading the full article
Subscribers to JCSM get full access to current and past issues of the JCSM.
Login to JCSM
Not a subscriber?
Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership