title: Sleep quality in patients with chronic illness.
abstract: OBJECTIVE
  To explore sleep quality in patients with chronic illness in primary care.
  
  
  BACKGROUND
  Many people suffer from chronic illness with the numbers increasing. One common issue arises from problems that people have with their quality of sleep: a largely under-researched topic. This study exploring poor quality sleep allowed patients to describe their daily struggles with poor sleep in their own lives. This allowed the development of a deeper understanding of what it means to sleep poorly and find out how participants cope with not sleeping well.
  
  
  METHODS
  A qualitative approach enabling a deep exploration of patient's experiences of sleep quality was used. Interviews were conducted with a purposive sample of nine participants from a primary care clinic. Analysis utilised an interpretative approach.
  
  
  RESULTS
  Data analysed produced four recurrent themes that were grouped into two categories. First, themes that identified the recognition by participants that 'something was wrong' were abrupt beginning and impact on their life. Second, themes that identified that the participants considered there was 'nothing wrong' were I am fine and I just carry on.
  
  
  CONCLUSIONS
  Data revealed that poor quality sleep can have a profound effect on quality of life. Participants lived without good quality sleep for years. They had come to accept two seemingly irreconcilable ideas that not being able to sleep is an enduring problem with a distinct starting point, and paradoxically, this is not a problem that deserves much professional attention.
  
  
  CONCLUSIONS
  Important original data were generated on the impact of poor quality sleep indicating that chronically disturbed sleep can increase the disease burden on patients with chronic illness. The results of this study suggest healthcare professionals need to understand how sleep quality issues impact on patient's experience of chronic illness. Data from this study will help nurses and other health professionals to deepen their understanding of the profound impact of poor quality sleep on patients with chronic illness. A programme of education highlighting the important role of sleep quality in chronic illness is suggested by the issues raised in this study. Nurses are ideally placed to assess sleep quality in patients and tailor intervention to positively affect the quality of life for this group.
authors.affiliation: School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland. mary.kemple@ucd.ie.
authors.forename: Mary
authors.initials: M
authors.lastname: Kemple
authors.affiliation: School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Sinead
authors.initials: S
authors.lastname: O'Toole
authors.affiliation: Slievemore General Practice, Slivemore Cliniccal, Stillorgan, Co. Dublin, Ireland.
authors.forename: Conor
authors.initials: C
authors.lastname: O'Toole
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing / Q000523:psychology*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D007407:Interviews as Topic; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000451:nursing / Q000523:psychology*
keywords: chronic illness; nursing interventions; poor quality sleep; qualitative study; sleep