delirium

Introduction Poor quality sleep is a risk factor for delirium in hospitalized patients. Objective The study aimed to investigate the relationship between subjective sleep quality and the presence of delirium, determine the discriminative ability of the Richards-Campbell Sleep Questionnaire (RCSQ) items, and analyze medications used to treat delirium during hospitalization. Methods A multicenter cross-sectional study was conducted from June 2023 to March 2024 in general wards of seven hospitals in the Czech Republic. The sample comprised 254 patients. Delirium was assessed daily by nurses using the Confusion Assessment Method (CAM) Short Form. Sleep quality was measured retrospectively each morning (days 2–4) using the RCSQ. Patients without delirium self-reported, while nurses assessed sleep in delirious patients. Results Patients with delirium had significantly longer hospital stays (8.25 vs. 7.12 days), consumed more alcohol (p < 0.001; τ = 0.242), and were more frequently admitted to medical wards (55.1%, p < 0.001; τ = 0.223). Throughout the three nights of the study, patients without delirium consistently had significantly higher scores than delirium patients on all RCSQ items, with the largest differences noted on the first night (RCSQ Total: 60.3 ± 26.2 vs. 30.5 ± 23.9; p < 0.001). The discriminative ability of individual RCSQ items was higher in patients without delirium than in delirium patients. The total RCSQ score demonstrated the greatest discriminative ability compared to individual items (Youden index 0.369 and 0.279 for patients without and with delirium, respectively). However, the items were not accurate enough to assess sleep quality independently. Patients with delirium used significantly more medications (p < 0.001), particularly antipsychotics and neuroleptics. Conclusion Patients with delirium had significantly poorer sleep quality and were more often treated with antipsychotics and neuroleptics. RCSQ items showed limited ability to distinguish sleep quality in this group.