Comparing quality and barriers to sleep in non-mechanically ventilated intensive care patients in intensive care unit and in hospital ward

Purpose: It is uncertain if quality and barriers of sleep differs based on the location of a patient in the hospital. Our aim was to compare the patient reported sleep quality (QoS) in non-mechanically ventilated patients in ICU and wards, and identify the barriers of sleep in ICU and in wards.

Methods: The survey assessed the QoS at three stages including the day immediately prior to hospital admission, after their last night spent in the ICU prior to discharge, and the first night in wards. Visual analogue scale (VAS) ranging from 0 to 10 was used, with 0 being the 'worst possible sleep' and 10 'best quality sleep'. The patients were also asked to identify the barriers to sleep in both ICU and wards.

Results: 51 patients were enrolled. The QoS was found to be significantly better in the wards than in the ICU [median 6 (IQR 4-8) vs. 5 (IQR 3-7), median difference 0.76, p = 0.04], as well as at home compared to the ICU [6 (IQR 5-8) vs. 5 (IQR 3-7), median difference 1.12 p = 0.046]. There was no statistical difference in median QoS at home compared to the wards. Noise, being awoken for procedures were the commonest barriers to sleep both in the ICU and ward.Medical devices (58.8% vs. 32%, p = 0.004) and being disorientated or confused (27.5% vs. 10%, p = 0.0135) were largely reported as barriers in ICU compared to the wards.

Conclusions: QoS in ICU is generally poorer than the wards. The use of medical devices and disorientation in ICU were the main differentiating factors between the ICU and the wards.