Sleep Quality and Disruptive Factors in Intensive Care Units: A Comparison Between Mechanically Ventilated and Spontaneously Breathing Patients.

Sleep was measured only by patient-reported questionnaires, not by objective sleep monitoring, so self-report bias cannot be ruled out. The first sleep assessment was after 24 hours of ICU stay, so sleep problems in the very early admission period may have been missed. The study was done in one ICU in Türkiye, so other units with different staffing, monitoring, noise or care patterns may not match. Only conscious, cooperative adults were included; sedated, delirious or cognitively impaired patients were excluded, so this does not describe the sleep of many critically ill patients. Ventilated patients were older, more severely ill, had lower consciousness scores and stayed longer, so poorer sleep may reflect their illness burden rather than ventilation alone. Medication doses and durations were not collected, and dexmedetomidine was used more often in ventilated patients, which could have affected sleep. Noise, light and alarms were not measured with objective devices, and pre-existing sleep problems were not screened with validated scales. Patients were recruited by convenience sampling, not random sampling.

The authors declare no conflicts of interest.

Do not conclude that mechanical ventilation itself caused the poorer sleep, because the ventilated group was older, more severely ill, had lower consciousness scores and longer ICU stays than the spontaneously breathing group. This study reports patient perceptions, not a tested sleep intervention.