Sleep Quality and Circadian Rhythm Disruption in Critically Ill Patients in Intensive Care Unit

Abstract

Aim:The aim of this study was to evaluate the quality of sleep in critically ill patients in the Intensive Care Unit (ICU). Method and Material:This study investigated the night-time sleep of 135 patients admitted to the general ICU of the General Hospital of Athens G. Gennimatas between January 2021 and December 2023. Data were collected using the Richards Campbell Sleep Questionnaire (RCSQ). Sensory stimuli, including noise, light, nursing activities, and invasive procedures, were reduced during the night to improve patients sleep. Measures to reduce light included implementing special lighting during nursing tasks and using bedside lamps during care. Noise reduction strategies involved closing doors, minimizing monitor alarms, and discouraging staff from speaking near patient beds. Grouping patient care activities was also promoted to limit sleep disturbances. Results:Patients in the intervention group showed improved sleep quality compared to the control group, with a significant overall RCSQ score (p<0.05). Gender and age did not significantly affect sleep quality. However, hospital stay duration differed between groups, with the control group experiencing shorter stays. A negative correlation was observed between the duration of hospitalization and sleep quality, with longer stays linked to lower RCSQ scores. Additionally, extended mechanical ventilation was associated with poorer sleep quality. Conclusion: Patients in the ICU often exhibit abnormal levels of alertness, poor quality of daytime sleep, disrupted nighttime sleep, and sleep patterns that lack both slow-wave and rapid eye movement (REM) sleep. Gaining a deeper understanding of the role circadian rhythms play in managing critical illness could pave the way for future chronotherapeutic strategies, enhancing clinical outcomes and promoting recovery for patients. Keywords: Intensive care unit, sleep quality, circadian rhythm