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Sleep quality and circadian rhythm disruption in critically ill patients in Intensive Care Unit

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Published: Apr 10, 2025
DOI: https://doi.org/10.12681/healthresj.38824
Keywords:
Intensive Care Unit sleep quality circadian rhythm
Athanasia-Christina Sampani
RN, MSc, PhD (c), General Hospital of Athens “G. Gennimatas”, Athens, Greece
https://orcid.org/0009-0005-1319-9068
Georgios Koukoulitsios
Intensivist, ICU Director, General Hospital of Athens “G. Gennimatas”, Athens, Greece
Athanasia Liveri
Department of Statistics and Insurance Science, University of Piraeus, Greece
Theodore Kapadohos
Assistant Professor, Department of Nursing, University of West Attica, Greece
Nikolaos Rikos
Assistant Professor, Hellenic Mediterranean University, School of Health Science, Department of Nursing, Heraklion, Greece
Dimitrios Papageorgiou
Associate Professor, Director of "ICU Follow-Up Care Lab", School of Health and Care Sciences, Department of Nursing, University of West Attica, Greece
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: ICU patients 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.

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