title: Sleep and psychological health during early recovery from critical illness: an observational study.
abstract: BACKGROUND
  Intensive care patients often report sleep disruption in ICU and during recovery from critical illness.
  
  
  OBJECTIVE
  To assess: (i) patients' self-reported sleep quality in ICU, on the hospital ward after transfer from ICU and two and six months after hospital discharge; (ii) whether patients who report sleep disruption in ICU continue to report sleep disruption in recovery and (iii) whether prehospital insomnia, experiences in intensive care, quality of life and psychological health are associated with sleep disruption six months after hospital discharge.
  
  
  METHODS
  Patients completed self-report measures on sleep quality at five time points: prior to hospitalization, in ICU, the hospital ward, two months and six months after hospital discharge, their intensive care experiences two months after discharge and psychological health and quality of life six months after discharge.
  
  
  RESULTS
  Patients (n=222) were aged (mean±SD) 57.2±17.2years, 35% female, had mean ICU stay of 5±6days and BMI of 26±5. Over half the participants (57%) reported poor sleep at six months; for 10% this was at all time points after ICU admission. Prehospitalization insomnia (p=.0005), sleep quality on the ward (p=.006), anxiety (p=.002), and mental (p=.0005) and physical health (p=.0005) were independently associated with poorer sleep quality in survivors six months after ICU treatment.
  
  
  CONCLUSIONS
  Sleep is a significant issue for more than half of survivors 6months after ICU treatment. Some influencing factors, such as hospital sleep quality, anxiety, physical health and mental health, are potentially modifiable and should be targeted in recovery programs.
authors.affiliation: University of Technology Sydney, Sydney, NSW Australia; Northern Sydney Local Health District, Sydney, NSW Australia. Electronic address: sharon.mckinley@uts.edu.au.
authors.forename: Sharon
authors.initials: S
authors.lastname: McKinley
authors.forename: Mary
authors.initials: M
authors.lastname: Fien
authors.forename: Rosalind
authors.initials: R
authors.lastname: Elliott
authors.forename: Doug
authors.initials: D
authors.lastname: Elliott
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D016638:Critical Illness / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010351:Patient Discharge; D011788:Quality of Life; D012890:Sleep; D017741:Survivors
keywords: Critical illness; Intensive care; Psychological health; Recovery; Sleep