title: Insomnia is associated with quality of life impairment in medical-surgical intensive care unit survivors.
abstract: OBJECTIVE
  To examine the prevalence of insomnia and its relationship to health-related quality of life (HRQOL) post-intensive care unit (ICU).
  
  
  BACKGROUND
  The burden of post-ICU insomnia is unknown.
  
  
  METHODS
  This cross-sectional study examined data from 120 patients with an ICU stay >24 h. Pre-hospital health was assessed in-hospital. Insomnia, HRQOL and post-ICU psychiatric symptoms were assessed at 12 months post-ICU.
  
  
  RESULTS
  Over one-quarter (28%) of subjects met insomnia criteria at 12 months post-ICU. Post-ICU insomnia was independently associated with worse mental HRQOL (P < 0.01), as well as worse scores on the HRQOL sub-domains of bodily pain (P < 0.001), vitality (P < 0.05) and physical function (P < 0.05). However, these associations were no longer significant after adjusting for post-ICU psychiatric symptoms (P = 0.33).
  
  
  CONCLUSIONS
  Insomnia is common among ICU survivors. Post-ICU insomnia is significantly associated with mental HRQOL and could identify ICU survivors who may benefit from further psychiatric evaluation.
authors.affiliation: VA Puget Sound Health Care System, Seattle, WA, USA; Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA. Electronic address: elizabeth.parsons@va.gov.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Parsons
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hough
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Vitiello
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Zatzick
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Dimitry S
authors.initials: DS
authors.lastname: Davydow
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology; D017741:Survivors / Q000523:psychology*
keywords: Critical care; Depression; Insomnia; Intensive care; Outcome assessment; Post-traumatic stress disorder