Evaluation of the Quality of Sleep and Barriers to Good Sleep Among Non-ventilated Critically Ill Patients

Background: Patients in the ICU frequently experience qualitative and quantitative sleep disruption. The Richards-Campbell Sleep Questionnaire (RCSQ) is a validated tool to assess the quality of sleep in critically ill patients. The aim of our study was to assess the quality of sleep in non-ventilated critically ill patients, explore reasons and evaluate patient and nurse perception of quality of sleep in critically ill patients. Patients and Methods: The study is a single-centre, prospective observational study conducted among non-ventilated patients in our tertiary critical care unit. After ruling out delirium in patients with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) delirium screening tool, the perception of sleep quality was assessed twice using the modified RCSQ, from the patient and the bedside nurse in an independent, blinded manner during the ICU stay. In addition, factors contributing to sleep disruption were assessed. Results: In our study, during the first assessment, the average sleep score was 57.2 (±18.4) and 65.0 (±19.4) ( P < .05), and the noise score was 52.3 (±23.8) and 61.8 (±26.1) for the patients and nurses ( P < .05), respectively. During the second assessment, the average sleep score was 62.8 (±15.4) and 70.0 (±12.0) ( P < .05), and the noise score was 62.9 (±16.4) and 72.4 (±15.8) for the patients and nurses ( P < .05), respectively. Noise level, nursing interventions and blood sampling were the predominant factors affecting sleep. Conclusion: Patients admitted to our ICU had moderate quality of sleep, which improved over time. Nurses overestimated sleep and underestimated noise levels compared to patients. Noise was the predominant factor affecting sleep.