Repeated sleep‐quality assessment and use of sleep‐promoting interventions in ICU

Abstract

To describe sleep quality using repeated subjective assessment and the ongoing use of sleep-promoting interventions in intensive care. It is well known that the critically ill experience sleep disruption while receiving treatment in the intensive care unit. Both the measurement and promotion of sleep is challenging in the complex environment of intensive care unit. Repeated subjective assessment of patients' sleep in the intensive care unit and use of sleep-promoting interventions has not been widely reported. An observational study was conducted in a 58-bed adult intensive care unit. Sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ) each morning. intensive care unit audit sleep-promoting intervention data were compared to data obtained prior to the implementation of a sleep guideline. Patients answered open-ended questions about the facilitators and deterrents of their sleep in intensive care unit. The sample (n = 50) was predominately male (76%) with a mean age: 62.6±16.9 years. Sleep quality was assessed on 2 days or more for 21 patients. The majority of patients (98%) received sleep-promoting interventions. Sleep quality had not improved significantly since the guideline was first implemented. The mean Richards-Campbell Sleep Questionnaire score was 47.9±24.1 mm. The main sleep deterrents were discomfort and noise. Frequently cited facilitators were nothing (i.e. nothing helped) and analgesia. The Richards-Campbell Sleep Questionnaire was used on repeated occasions, and sleep-promoting interventions were used extensively. There was no evidence of improvement in sleep quality since the implementation of a sleep guideline. The use of the Richards-Campbell Sleep Questionnaire for the subjective self-assessment of sleep quality in intensive care unit patients and the implementation of simple-promoting interventions by intensive care unit clinicians is both feasible and may be the most practical way to assess sleep in the intensive care unit context.

The effects of noise levels on pain, anxiety, and sleep in patients

“…Simons et al investigated the relationship between noise in intensive care and sleep quality and reported a 24‐hour noise level of 54.0 dBA (± 2.4) and a mean RCSQ score of 56 ± 24, concluding that noise levels are significantly correlated with sleep quality 41 . Menear et al and Carrera‐Hernández et al examined sleep quality and associated factors in patients in intensive care and reported mean RCSQ values of 47.9 ± 24.1 and 52.92, respectively, both emphasizing that sleep quality is particularly affected by noise 42,43 . Studies 44,45 have also emphasized that noise experienced in the ICU produces direct adverse physiological and psychological effects and can result in indirect negative health outcomes deriving from decreased sleep quality and duration, difficulty in falling asleep, and excessive noise levels, which have been reported in ICUs 46 .…”

Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality

“…The RCSQ was able to be completed in 100% of attempts, a completion rate higher than other studies, [28][29][30] that demonstrates its feasibility when administered as a repeated assessment in an ICU cohort. Overall, sleep was classified as fair with a mean RCSQ of 52±25, which is comparable to previously reported ICU means of 34-60.…”

“…Overall, sleep was classified as fair with a mean RCSQ of 52±25, which is comparable to previously reported ICU means of 34-60. [28][29][30] The even distribution of RCSQ scores across poor, fair and good sleep groups suggests that all correlation efforts were conducted across the entire spectrum of patient-perceived sleep quality.…”

Associations between Parents’ Health Literacy and Sleeping Hours in Children: A Cross-Sectional Study

“…Sixth, previous studies suggested that long naps affect nighttime sleep patterns [ 35 , 36 ] and the quality of sleep [ 37 ]. Not only the total sleeping time but also the quality of the sleep is important [ 38 , 39 , 40 , 41 , 42 ]. However, we did not collect information relevant to childhood development, sleep quality and individual family patterns of sleep behavior, which are significant factors for the sleep of children and the issue of poor parenting.…”