Clinical Care Interaction and Patient Sleep in the Intensive Care Unit: A Secondary Data Analysis.
Aliya Islam, Lori Delaney
PMID 41969025WHAT IT FOUND
ICU patients experienced poor sleep and 93.7 clinical interactions over 24 hours on average, but interaction count was not associated with sleep time or perceived quality.
Higher organ dysfunction was associated with more interactions; lower acuity and higher inflammation with poorer sleep.
Key findings
01Patient-reported sleep was poor, with a mean Richards-Campbell Sleep Questionnaire total score of 47.5, and overnight actigraphy showed a mean of 33.4 awakenings.
02Patients experienced a mean of 93.7 clinical interactions over 24 hours, but interaction frequency was not significantly associated with total sleep time, sleep efficiency, or perceived sleep quality.
03Higher SOFA scores were associated with more clinical interactions, while lower APACHE II scores and higher CRP were associated with poorer sleep.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The secondary analysis included 37 of the original 80 participants, was limited in sample size, and was not adequately powered. The analysed patients were largely non-intubated and may not represent the acuity or complexity of broader ICU populations. The patient group was heterogeneous, so definitive conclusions about how different conditions affect sleep are difficult. Patients may have expected poor sleep in ICU, which could bias self-reported perceptions. The study was observational and did not test whether reducing or clustering clinical interactions improves sleep. Actigraphy infers sleep from movement, so it does not directly measure sleep architecture.
Declared interests
The authors report nothing to report for funding and declare no conflicts of interest.
The easy way to misread this
Do not conclude that reducing clinical interactions will improve ICU sleep. The study found no significant correlation between interaction frequency and total sleep time, sleep efficiency, or perceived sleep quality, and it did not test a care-reduction intervention.