Intensive & critical care nursing · 2026
Subjective and objective sleep measurements in ICU Patients: A longitudinal analysis of 706 sleep episode pairs.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Kang Jiyeon, Cho Hyeonjin
Аннотация
OBJECTIVES: Sleep disturbance is highly prevalent among intensive care unit (ICU) patients, yet accurate assessment remains challenging. This study aims to evaluate both subjective and objective sleep measures in ICU patients and to examine their interrelationship and associated clinical factors.
METHODS: A prospective observational multi-centre study was conducted from July 2022 to December 2024 in six ICUs across three university hospitals in Busan, Korea. Adult patients expected to be admitted for more than 48 h were enrolled. Subjective sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ). Objective sleep parameters were obtained via Fitbit Sense wearable devices. Linear mixed-effects models evaluated associations between sleep outcomes and patient characteristics. Data from 355 patients yielding 706 paired sleep episodes (nights with both subjective and objective measurements) were analysed.
RESULTS: Mean RCSQ scores declined from 56.67 ± 26.56 on Day 1 to 51.74 ± 25.72 on Day 5, while sleep efficiency declined from 83.23 ± 17.21% to 74.07 ± 25.57%. Subjective sleep quality was significantly associated with illness severity, current smoking, surgical admission, mechanical ventilation, and analgesic/sedative use. Objective sleep quality was associated with age, delirium, high-flow oxygen therapy, and analgesic/sedative use. The correlation between subjective and objective measures was modest (sleep efficiency: β = 0.158; wake after sleep onset: β = -0.165), with stronger associations among patients with higher illness severity and current smokers.
CONCLUSIONS: Subjective and objective sleep assessments correlate only modestly in ICU patients, indicating each method captures unique information. Reliance on a single assessment method may result in incomplete understanding of sleep disruption.
IMPLICATIONS FOR CLINICAL PRACTICE: ICU nurses should incorporate both patient-reported and objective sleep assessments to comprehensively evaluate sleep disturbances. This dual-assessment approach enables identification of patients requiring tailored interventions, supporting evidence-based, individualized sleep-promotion protocols in critical care nursing practice.
METHODS: A prospective observational multi-centre study was conducted from July 2022 to December 2024 in six ICUs across three university hospitals in Busan, Korea. Adult patients expected to be admitted for more than 48 h were enrolled. Subjective sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ). Objective sleep parameters were obtained via Fitbit Sense wearable devices. Linear mixed-effects models evaluated associations between sleep outcomes and patient characteristics. Data from 355 patients yielding 706 paired sleep episodes (nights with both subjective and objective measurements) were analysed.
RESULTS: Mean RCSQ scores declined from 56.67 ± 26.56 on Day 1 to 51.74 ± 25.72 on Day 5, while sleep efficiency declined from 83.23 ± 17.21% to 74.07 ± 25.57%. Subjective sleep quality was significantly associated with illness severity, current smoking, surgical admission, mechanical ventilation, and analgesic/sedative use. Objective sleep quality was associated with age, delirium, high-flow oxygen therapy, and analgesic/sedative use. The correlation between subjective and objective measures was modest (sleep efficiency: β = 0.158; wake after sleep onset: β = -0.165), with stronger associations among patients with higher illness severity and current smokers.
CONCLUSIONS: Subjective and objective sleep assessments correlate only modestly in ICU patients, indicating each method captures unique information. Reliance on a single assessment method may result in incomplete understanding of sleep disruption.
IMPLICATIONS FOR CLINICAL PRACTICE: ICU nurses should incorporate both patient-reported and objective sleep assessments to comprehensively evaluate sleep disturbances. This dual-assessment approach enables identification of patients requiring tailored interventions, supporting evidence-based, individualized sleep-promotion protocols in critical care nursing practice.