Environmental Factors Affecting Sleep Quality in Intensive Care Unit Patients in Southern Morocco: An Assessment Study.

INTRODUCTION

Sleep disturbances are a common and often underestimated complication during intensive care unit (ICU) stays. These disturbances can significantly impact patients' recovery and overall well-being. This study aimed to assess the sleep quality of ICU patients and investigate the environmental and clinical factors that affect sleep quality during their ICU stay.

METHODS

We conducted a six-month cross-sectional study involving patients who had stayed in the ICU for at least three nights and were oriented to time and place upon discharge. Sleep quality was assessed using the Arabic version of the Freedman Sleep Questionnaire. Both environmental factors (e.g., noise, light, and nursing interventions) and clinical variables (illness severity and pain) were examined. The differences across three time periods were analyzed using the Wilcoxon test and Spearman's correlation. Multiple regression analysis identified the factors influencing sleep quality. Statistical analyses were performed using JAMOVI software (version 2.3.28).

RESULTS

The study enrolled 328 patients, with an average age of 49.74 ± 17.89 years. Of the participants, 75.3% were adults. The primary reasons for admission were circulatory distress (45.73%) and metabolic disorders (24.09%). Sleep quality was significantly lower in the ICU compared to patients' sleep at home (Z = -14.870, < 0.001). The EVA and APACHE II scores had a statistically significant effect on sleep quality ( < 0.001 and = 0.015, respectively). In contrast, the Charlson and Quick SOFA scores did not show significant effects ( = 0.128 and = 0.894). Environmental factors, including noise ( = 0.008), light ( = 0.009), and nursing interventions ( = 0.009), significantly impacted sleep quality.

CONCLUSIONS

Patients in the ICU generally reported poor sleep quality. Our findings suggest that improving pain management, minimizing environmental noise, and reducing staff-related disturbances could significantly enhance sleep quality for patients in the intensive care unit (ICU).