Skip to main content
  • Original article
  • Open access
  • Published:

Study of sleep quality among patients admitted to the respiratory intensive care unit

Abstract

Background

Several factors may cause sleep disruption among critically ill patients. Determination of these factors that interfere with patients’ quality of sleep is very important in the treatment process to ensure normal sleep process.

Objective

The aim was to assess the quality of sleep among critically ill patients admitted to the respiratory intensive care unit (RICU) and identify the risk factors.

Materials and methods

This observational study was carried out on all patients who were admitted to the RICU. Patients’ age, gender, duration of ICU stay, cause of admission, and scores for the severity of illness on admission including Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment were done. A Freedman questionnaire was determined twice: at the RICU and at home to evaluate sleep quality and the contributing factors.

Results

One hundred patients were enrolled in this study. The mean ICU stay was 5.41±2.03 days; 82% of them were admitted for the first time to the RICU. The mean score of sleep quality of patients at the RICU was 4.38±1.83, which was significantly reduced compared with the mean score at home post-admission 8.30±1.09 (P<0.001). Noise (7.60 ±1.40) was the main sleep disruptive factor in the RICU; hospital staff conversations (7.77±1.38) and medical staff pagers and phones (7.42±1.53) were the maximum noises. Frequent use of light is the second influential factor for sleep disruption (6.82±1.31), followed by nursing interventions and blood sampling.

Conclusion

Due to the poor sleep quality during hospitalization and due to the presence of a wide range of sleep disturbing factors such as noise, light, and nursing activities, nursing education, using eye shields, and ear plugs might reduce environmental noise and improve sleep quality.

References

  1. Parthasarathy S, Tobin MJ. Sleep in the intensive care unit. Intensive Care Med 2004; 30: 197–206.

    Article  Google Scholar 

  2. Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ. Sleep in critically ill patients requiring mechanical ventilation. Chest 2000; 117: 809–818.

    Article  CAS  Google Scholar 

  3. Freedman NS, Gazendam J, LevanL, Pack AI, Schwab RJ. Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med 2001; 163: 451–457.

    Article  CAS  Google Scholar 

  4. Leung RS, Bradley TD. Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med 2001; 164: 2147–2165.

    Article  CAS  Google Scholar 

  5. Mahmoud MI, Morsi T, Gharraf H, ElHady H. Study of sleep-related breathing disorders in patients admitted to respiratory intensive care unit. Egypt J Chest Dis Tuberc 2016; 65: 89–98.

    Article  Google Scholar 

  6. Fontana CJ, Pittiglio LI. Sleep deprivation among critical care patients. Crit Care Nurs 2010; 33: 75–81.

    Google Scholar 

  7. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13: 818–829.

    Article  CAS  Google Scholar 

  8. Arts DG, de Keizer NF, Vroom MB, de Jonge E. Reliability and accuracy of Sequential Organ Failure Assessment (SOFA) scoring. Crit Care Med 2005; 33: 1988–1993.

    Article  CAS  Google Scholar 

  9. Freedman SN, Kotzer N, Richard JS. Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit. Am J Respir Crit Care Med 1999; 159: 1155–1162.

    Article  CAS  Google Scholar 

  10. Li SY, Wang TJ, Vivienne Wu SF, Liang SY, Tung HH. Efficacy of controlling night-time noise and activities to improve patients’ sleep quality in a surgical intensive care unit. J Clin Nurs 2011; 20: 396–407.

    Article  Google Scholar 

  11. Atar NY, Kırbıyık E, Turan N, Pallos A, Eskimez Z. Patients’ sleep quality and factors affecting sleep in surgery clinic of one university hospital. J Nurs Sci 2012; 4: 74–84.

  12. Lei Z, Qiongjing Y, Qiuli W, Sabrina K, Xiaojing L, Changli W. Sleep quality and sleep disturbing factors of inpatients in a Chinese general hospitals. J Clin Nurs 2009; 18: 2521–2529.

    Article  Google Scholar 

  13. Taştan S, Ünver V, Đyigün E, Đyisoy A. Study on effects of intensive care environment on sleep state of patients. Anatol J Clin Investig 2010; 4: 5–10.

    Google Scholar 

  14. Uǧras GA, Öztekin SD. Patient perception of environmental and nursing factors contributing to sleep disturbances in a neurosurgical intensive care unit. Tohoku J Exp Med 2007; 212: 299–308.

    Article  Google Scholar 

  15. Xie H, Kang J, Mills GH. Clinical review: the impact of noise on patients sleep and the effectiveness of noise reduction stragies in intensive care units. Crit Care 2009; 13: 2–8.

    Article  Google Scholar 

  16. Drouot X, Cabello B, d’Ortho MP, Brochard L. Sleep in the intensive care unit. Sleep Med Rev 2008; 12: 391–403.

    Article  Google Scholar 

  17. Dunn H, Anderson MA, Hill PD. Nighttime lighting in intensive care units. Crit Care Nurse 2010; 30: 31–37.

    Article  Google Scholar 

  18. Bihari S, Doug McEvoy R, Matheson E, Kim S, Woodman RJ, Bersten AD. Factors affecting sleep quality of patients in intensive care unit. J Clin Sleep Med 2012; 8: 301–307.

    Article  Google Scholar 

  19. Gabor JY, Cooper AB, Crombach SA, Lee B, Kadikar N, Bettger HE, Hanly PJ. Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects. Am J Respir Crit Care Med 2003; 167: 708–715.

    Article  Google Scholar 

  20. Çelik S, Oztekin D, Akyolcu N, Işsever H. Sleep disturbance: the patient care activities applied at the night shift in the intensive care unit. J Clin Nurs 2005; 14: 102–106.

    Article  Google Scholar 

  21. Bihari S, McEvoy RD, Matheson E, Kim S, Woodman RJ, Bersten AD. Factors affecting sleep quality of patients in intensive care unit. J Clin Sleep Med 2012; 8: 301–307.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Doaa M. Magdy MD.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Magdy, D.M., Metwally, A. & Makhlouf, H.A. Study of sleep quality among patients admitted to the respiratory intensive care unit. Egypt J Bronchol 13, 114–119 (2019). https://doi.org/10.4103/ejb.ejb_10_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejb.ejb_10_18

Keywords