Clinical Care Interaction and Patient Sleep in the Intensive Care Unit: A Secondary Data Analysis

Area of Science:

• Critical care medicine
• Sleep science
• Patient monitoring

Background:

• Sleep is vital for health, yet intensive care unit (ICU) patients face significant sleep disturbances due to constant monitoring and care.
• The impact of clinical interactions on ICU patient sleep quality is not well understood.

Purpose of the Study:

• To investigate the link between clinical interactions, patient acuity, and inflammatory markers on sleep quality in ICU patients.
• To objectively and subjectively characterize sleep patterns in ICU patients.

Main Methods:

• Secondary analysis of a clinical trial data from a 36-bed tertiary ICU.
• Utilized patient-reported sleep quality (Richard-Campbell's Sleep Questionnaire) and objective sleep monitoring (Actigraphy).
• Extracted clinical interaction data from electronic patient records (Metavision).

Main Results:

• Patients reported poor sleep quality (mean RCSQ scores <50 mm) and experienced fragmented sleep (median 5.6 hours/night, 33.4 awakenings/hour).
• Frequent clinical interactions (median 9/hour) occurred, with assessments being most common (32.8%).
• Higher patient acuity (SOFA scores) correlated with more interactions, while lower acuity (APACHE II scores) was linked to greater sleep disturbance.

Conclusions:

• ICU patients exhibit significantly impaired sleep, characterized by fragmentation and low perceived quality.
• Frequent clinical interactions did not appear to be the primary driver of poor sleep quality.
• Lower acuity patients are disproportionately affected, necessitating tailored sleep support strategies in ICUs.