Disruptive Factors

Background: Quality sleep is essential, and sleeping difficulty is a significant source of discomfort for patients in the intensive care unit (ICU). Aim and objective of the study: This study aimed to assess sleep quality and daytime sleepiness in patients admitted to the ICU and examine the environmental and non-environmental factors influencing sleep quality. Method: A multicentre descriptive cross-sectional study was carried out on 267 patients admitted to ICUs across six hospitals in the Czech Republic. On the day of discharge, factors influencing their sleep were assessed using a modified Freedman questionnaire. Data analysis involved descriptive statistics, an ANOVA model, and multivariate regression (OPLS). The study was approved by the Ethics Committee of the author´s institution (Approval No. R2/2021). Findings: The overall sleep quality in the ICU was significantly lower than at home (5.16 vs. 6.99, p <0.001). Men reported significantly better sleep quality than women (5.26 vs. 4.80, p <0.001), while individuals over 60 years of age experienced poorer sleep (5.99 vs. 6.17, p <0.001). Sleep quality improved throughout hospitalisation (4.24 vs. 5.20 vs. 5.66, p <0.001). Daytime sleepiness was associated with gender, with women reporting higher levels than men (5.02 vs 5.50, p <0.001) and increased as the duration of hospitalisation lengthened (5.72 vs 5.32 vs 4.76, p <0.001). A statistically significant but weak correlation (r = 0.206, p <0.001) was observed between sleep quality and daytime sleepiness. The top five factors that most significantly disrupted sleep was medication administration (-0.804), pain (-0.623), noise (-0.588), light (-0.555), and nursing interventions (-0.504), based on component loadings. Conclusion and impact: Sleep disruption in ICU patients can be attributed to various multifactorial causes, encompassing environmental and non-environmental factors. It is essential to develop targeted interventions and strategies to reduce these disruptions and enhance the overall quality of care for patients in the ICU.