Prospective repeated assessment of self-reported sleep quality and sleep disruptive factors in the intensive care unit: acceptability of daily assessment of sleep quality

Ghaida Alsulami*, Ann Marie Rice, Lisa Kidd

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)
16 Downloads (Pure)


Introduction Despite the importance of sleep, the assessment of sleep quality does not form part of standard clinical care in intensive care unit (ICU). Continuous assessment of self-reported quality of ICU patients’ sleep has been strongly recommended. Prior to implementing such an assessment in the ICU, it is important to assess the acceptability of this method of assessment to the ICU’s patients. The aims of this study were to assess the acceptability to ICU patients of completing daily self-reports on sleep quality during their ICU stay and to assess ICU patients’ self-reported sleep quality and sleep disruptive factors during their time in ICU.

Methods An observational prospective-repeated assessment was conducted on n=120 patients in an ICU in Saudi Arabia. The participants were both intubated and non-intubated.

Outcomes measures Over a 3-month period, sleep quality was assessed using the Arabic version of the Richards-Campbell Sleep Questionnaire (RCSQ-A), and self-reported sleep disruptive factors were identified. Clinical factors, such as ICU interventions, and previously administered sedatives were also examined. The patients’ acceptance of completing daily RCSQ-A reports was assessed using various indicators of acceptability.

Results A total of 381self-reports (RCSQ-A) were collected for this analysis. The patients reported34.4±5.60, indicating that sleep quality was poor on average. The group of intubated patients reported much poorer sleep quality during intubation than after extubation. In the multivariate analysis, factors which most significantly affected sleep (exp(b), p value) were midazolam (−6.424,p<0.0005), propofol (−3.600, p<0.05), noise (−1.033, p<0.05), gender(1.836, p<0.05), daytime sleepiness (0.856, p<0.05) and the presence of mechanical ventilation (−1.218, p<0.05).

Conclusion The acceptability and feasibility of using daily RCSQ-A for sleep quality assessment was demonstrated. Sleep quality was reported as poor by all participants and the factors affecting sleep were varied. This study provided various recommendations for healthcare providers and researchers in terms of evaluating and improving sleep quality in ICU patients.

Original languageEnglish
Article numbere029957
Number of pages11
JournalBMJ Open
Issue number6
Early online date20 Jun 2019
Publication statusPublished - 20 Jun 2019


  • acceptability
  • factors affecting sleep
  • intensive care unit
  • richards campbell sleep questionnaire
  • self-report
  • sleep quality
  • Intensive Care Units
  • prospective studies
  • humans
  • middle aged
  • self report
  • self-assessment quizzes
  • male
  • sleep deprivation/epidemiology
  • sleep hygiene
  • young adult
  • adult
  • Female
  • surveys and questionnaires
  • aged

ASJC Scopus subject areas

  • Medicine(all)


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