Factors affecting sleep quality of patients in intensive care unit.
BACKGROUND
Sleep disturbance is a frequently overlooked complication of intensive care unit (ICU) stay.


OBJECTIVE
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 (R(2) = 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.


CONCLUSIONS
Reduced sleep quality is a common problem in ICU with a multifactorial etiology.
Department of Intensive and Critical Care Medicine, Flinders Medical Centre, Bedford Park South Australia, Australia.
Shailesh
S
Bihari
R
R
Doug McEvoy
Elisha
E
Matheson
Susan
S
Kim
Richard J
RJ
Woodman
Andrew D
AD
Bersten
D018806:APACHE; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D012720:Severity of Illness Index; D012890:Sleep / Q000187:drug effects; D012892:Sleep Deprivation / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires