Miranda-Ackerman Roberto Carlos, Lira-Trujillo Mariana, Gollaz-Cervantez Alma Carolina, Cortés-Flores Ana Olivia, Zuloaga-Fernández Del Valle Carlos José, García-González Luis Alberto, Morgan-Villela Gilberto, Barbosa-Camacho Francisco José, Pintor-Belmontes Kevin Josue, Guzmán-Ramírez Bertha Georgina, Bernal-Hernández Aldo, Fuentes-Orozco Clotilde, González-Ojeda Alejandro
Hospital San Javier, Guadalajara, Jalisco, Mexico.
Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Avenida Belisario Domínguez # 1000 Col. Independencia, 44340, Guadalajara, Jalisco, Mexico.
BMC Health Serv Res. 2020 Jul 9;20(1):631. doi: 10.1186/s12913-020-05497-8.
Patients admitted to the intensive care unit (ICU) experience sleep disruption caused by a variety of conditions, such as staff activities, alarms on monitors, and overall noise. In this study, we explored the relationship between noise and other factors associated with poor sleep quality in patients.
This was a prospective cohort study. We used the Richards-Campbell Sleep Questionnaire to explore sleep quality in a sample of patients admitted to the ICU of a private hospital. We measured the noise levels within each ICU three times a day. After each night during their ICU stay, patients were asked to complete a survey about sleep disturbances. These disturbances were classified as biological (such as anxiety or pain) and environmental factors (such as lighting and ICU noise).
We interviewed 71 patients; 62% were men (mean age 54.46 years) and the mean length of stay was 8 days. Biological factors affected 36% and environmental factors affected 20% of the patients. The most common biological factor was anxiety symptoms, which affected 28% of the patients, and the most common environmental factor was noise, which affected 32.4%. The overall mean recorded noise level was 62.45 dB. Based on the patients' responses, the environmental factors had a larger effect on patients' sleep quality than biological factors. Patients who stayed more than 5 days reported less sleep disturbance. Patients younger than 55 years were more affected by environmental and biological factors than were those older than 55 years.
Patient quality of sleep in the ICU is associated with environmental factors such as noise and artificial lighting, as well as biological factors related to anxiety and pain. The noise level in the ICU is twice that recommended by international guides. Given the stronger influence of environmental factors, the use of earplugs or sleeping masks is recommended. The longer the hospital stay, the less these factors seem to affect patients' sleep quality.
入住重症监护病房（ICU）的患者会因各种情况而睡眠中断，如医护人员活动、监护仪警报及整体噪音。在本研究中，我们探讨了噪音与患者睡眠质量差的其他相关因素之间的关系。
这是一项前瞻性队列研究。我们使用理查兹 - 坎贝尔睡眠问卷来探究一家私立医院ICU收治的患者样本的睡眠质量。我们每天三次测量每个ICU内的噪音水平。在患者入住ICU期间的每个夜晚过后，要求他们完成一份关于睡眠干扰的调查问卷。这些干扰被分类为生物因素（如焦虑或疼痛）和环境因素（如照明和ICU噪音）。
我们采访了71名患者；62%为男性（平均年龄54.46岁），平均住院时间为8天。生物因素影响了36%的患者，环境因素影响了20%的患者。最常见的生物因素是焦虑症状，影响了28%的患者，最常见的环境因素是噪音，影响了32.4%。记录的总体平均噪音水平为62.45分贝。根据患者的回答，环境因素对患者睡眠质量的影响大于生物因素。住院超过5天的患者报告的睡眠干扰较少。55岁以下的患者比55岁以上的患者受环境和生物因素的影响更大。
ICU患者的睡眠质量与噪音和人工照明等环境因素以及与焦虑和疼痛相关的生物因素有关。ICU中的噪音水平是国际指南推荐水平的两倍。鉴于环境因素的影响更强，建议使用耳塞或睡眠面罩。住院时间越长，这些因素对患者睡眠质量的影响似乎越小。
