Assessment of sleep quality in patients during hospitalisation
An exploratory study
DOI:
https://doi.org/10.14528/snr.2025.59.3.3302Keywords:
sleep, waking up; noise; artificial light; nursing activities, waking up, noise, artificial light, nursing activitiesAbstract
Background: During illness, quality sleep is crucial as it has a positive effect on metabolism, hormone regulation, and immune system maintenance. The aim of this study was to assess the sleep quality of hospitalised patients and identify the factors affecting it.
Methods: A non-experimental quantitative research method was used. The survey instrument consisted of the Richards Campbell Sleep Questionnaire and an additional 13 questions based on a literature review. The study sample consisted of 100 patients: 56 (56%) women and 44 (44%) men. Respondents' ages ranged from 19 to 89 years (x = 65.37, s = 15.676). The mean length of stay was 13.6 days (x = 13.68, s = 12.178).
Results: Sleep quality during hospitalisation was rated as poor (26.0%) and very poor (12.5%) by a total of 38.5% of patients. Women were statistically significantly more likely than men to report shallow sleep ( x = 60.80, s = 28.88) (U = 865.500, p = 0.011). Length of hospitalisation was not associated with sleep quality (r = –0.154, p = 0.127). Nighttime corridor noise outside the patient's room at night was reported as disturbing by 5.0% of patients. Noise from nurses attending to other patients in the same room was rated as disturbing by 8.0% of the patients.
Discussion and conclusion: Less than half of patients rated their sleep quality during hospitalisation as poor or very poor. Strategies to improve sleep quality should be a key component of quality care for hospitalised patients.
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Almondes, K. M. de, Marín Agudelo, H. A., & Jiménez-Correa, U. (2021). Impact of sleep deprivation on emotional regulation and the immune system of healthcare workers as a risk factor for COVID-19: Practical recommendations from a task force of the Latin American Association of Sleep Psychology. Frontiers in Psychology, 12, Article 564227. https://doi.org/10.3389/fpsyg.2021.564227
Altena, E., Baglioni, C., Espie, C. A., Ellis, J., Gavriloff, D., Holzinger, B., Schlarb, A., Frase, L., Jernelöv, S., & Riemann, D. (2020). Dealing with sleep problems during home confinement due to the COVID-19 outbreak: Practical recommendations from a task force of the European CBT-I Academy. Journal of Sleep Research, 29(4), Article e13052. https://doi.org/10.1111/jsr.13052 PMid:32266783; PMCid:PMC7262070
Barros, M. B. de A., Lima, M. G., Ceolim, M. F., Zancanella, E., & Cardoso, T. A. M. de O. (2019). Quality of sleep, health and well-being in a population-based study. Revista De Saúde Pública, 53, Article 82. https://doi.org/10.11606/s1518-8787.2019053001067
Brito, R. A., do Nascimento Rebouças Viana, S. M., Beltrão, B. A., de Araújo Magalhães, C. B., de Bruin, V. M. S., & de Bruin, P. F. C. (2020). Pharmacological and non-pharmacological interventions to promote sleep in intensive care units: A critical review. Sleep and Breathing, 24, 25–35. https://doi.org/10.1016/j.sleepe.2020.04.003 PMid:32270233; PMCid:PMC7141606
Caddick, Z. A., Gregory, K., Arsintescu, L., & Flynn-Evans, E. E. (2018). A review of the environmental parameters necessary for an optimal sleep environment. Building and Environment, 132, 11–20. https://doi.org/10.1016/j.buildenv.2018.01.008
Chen, J., Chen, N., Huang, T., Huang, N., Zhuang, Z., & Liang, H. (2022). Sleep pattern, healthy lifestyle and colorectal cancer incidence. Journal of Clinical Sleep Medicine, 18(3), 573–584. https://doi.org/10.5664/jcsm.9532 PMid:35225524; PMCid:PMC8865532
Cho, Y., Ryu, S.-H., Lee, B. R., Kim, K. H., Lee, E., & Choi, J. (2015). Effects of artificial light at night on human health: A literature review of observational and experimental studies applied to exposure assessment. Chronobiology International, 32(9), 1294–1310. https://doi.org/10.3109/07420528.2015.1073155 PMid:26373238; PMCid:PMC4812194
Dangol, M., Shrestha, S., & Rai Koirala, S. K. (2020). Insomnia and its associated factors among older people of selected ward of Banepa municipality, Nepal. Nursing Open, 7(1), 355–363. https://doi.org/10.1002/nop2.421 PMid:31659129; PMCid:PMC6962393
Dehvan, F., Dalvand, S., Mirhassani, K., Amini, M., Hosseini, S., Kheirabadi, P., & Ghanei-Gheshlagh, R. (2019). Evaluation of the relationship between depression, anxiety, and stress with sleep quality in nursing students. Journal of Sleep Sciences, 4(3–4), 81–85. https://doi.org/10.18502/jss.v4i3-4.3451
Devlin, J. W., Skrobik, Y., Gélinas, C., Needham, D. M., Slooter, A. J. C., Pandharipande, P. P., Watson, P. L., Weinhouse, G. L., Nunnally, M. E., & Rochwerg, B. (2018). Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine, 46(9), e825–e873. https://doi.org/10.1097/CCM.0000000000003299 PMid:30179977; PMCid:PMC6135825
Dobing, S., Frolova, N., McAlister, F., & Ringrose, J. (2016). Sleep quality and factors influencing self-reported sleep duration and quality in the general internal medicine inpatient population. PLoS One, 11(6), Article e0156735. https://doi.org/10.1371/journal.pone.0156735 PMid:27331940; PMCid:PMC4914042
DuBose, J. R., & Hadi, K. (2016). Improving inpatient environments to support patient sleep. International Journal for Quality in Health Care, 28(5), 540–553. https://doi.org/10.1093/intqhc/mzw079 PMid:27512130; PMCid:PMC5134570
Ettinger, U., & Kumari, V. (2015). Effects of sleep deprivation on inhibitory biomarkers of schizophrenia: Implications for drug development. The Lancet Psychiatry, 2(11), 1028–1035. https://doi.org/10.1016/S2215-0366(15)00233-1 PMid:26478196
Gates, K. M., Lane, S. T., Varangis, E., Giovanello, K., & Guiskewicz, K. (2017). Unsupervised classification during time-series model building. Multivariate Behavioral Research, 52(2), 129–148. https://doi.org/10.1080/00273171.2016.1256187 PMid:27834419; PMCid:PMC5594605
Hastings, M. H., Maywood, E. S., & Brancaccio, M. (2018). Generation of circadian rhythms in the suprachiasmatic nucleus. Nature Reviews Neuroscience, 19(8), 453–469. https://doi.org/10.1038/s41583-018-0026-z PMid:29992991; PMCid:PMC6066557
Ibáñez, V., Silva, J., & Cauli, O. (2018). A survey on sleep assessment methods. PeerJ, 6, Article e4849. https://doi.org/10.7717/peerj.4849 PMid:29844990; PMCid:PMC5971842
Irwin, M. R. (2019). Sleep and inflammation: Partners in sickness and in health. Nature Reviews Immunology, 19(11), 702–715. https://doi.org/10.1038/s41577-019-0190-z PMid:31289370
Ito, E., & Inoue, Y. (2015). The international classification of sleep disorders, American Academy of Sleep Medicine. Nihon Rinsho. Japanese Journal of Clinical Medicine, 73(6), 916–923.
Javadi, N., Darvishpour, A., Mehrdad, N., & Lakeh, N. M. (2015). Survey of sleep status and its related factors among hospitalized patients with heart failure. The Journal of Tehran University Heart Center, 9.
Tomažič, J., Lešnik, A., & Dobnik, M. (2025). [Article in Slovenian]. Obzornik zdravstvene nege, 59(3), 162–171.
Khan, M. A., & Al-Jahdali, H. (2023). The consequences of sleep deprivation on cognitive performance. Neurosciences Journal, 28(2), 91–99. https://doi.org/10.17712/nsj.2023.2.20220108 PMid:37045455; PMCid:PMC10155483
Kheirinejad, S., Visuri, A., Ferreira, D., & Hosio, S. (2023). 'Leave your smartphone out of bed': Quantitative analysis of smartphone use effect on sleep quality. Personal and Ubiquitous Computing, 27(2), 447–466. https://doi.org/10.1007/s00779-022-01694-w PMid:36405389; PMCid:PMC9643910
Kim, T. W., Jeong, J.-H., & Hong, S.-C. (2015). The impact of sleep and circadian disturbance on hormones and metabolism. International Journal of Endocrinology, 2015, Article 591729. https://doi.org/10.1155/2015/591729 PMid:25861266; PMCid:PMC4377487
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije. (2014). Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Krotsetis, S., Richards, K. C., Behncke, A., & Köpke, S. (2017). The reliability of the German version of the Richards Campbell Sleep Questionnaire. Nursing in Critical Care, 22(4), 247–252. https://doi.org/10.1111/nicc.12181 PMid:27481434
Kulpatcharapong, S., Chewcharat, P., Ruxrungtham, K., Gonlachanvit, S., Patcharatrakul, T., Chaitusaney, B., Muntham, D., Reutrakul, S., & Chirakalwasan, N. (2020). Sleep quality of hospitalized patients, contributing factors, and prevalence of associated disorders. Sleep Disorders, 2020, Article 8518396. https://doi.org/10.1155/2020/8518396 PMid:32082386; PMCid:PMC7005680
Mathias, J. L., Cant, M. L., & Burke, A. L. J. (2018). Sleep disturbances and sleep disorders in adults living with chronic pain: A meta-analysis. Sleep Medicine, 52, 198–210. https://doi.org/10.1016/j.sleep.2018.05.023 PMid:30314881
Matsuda, R., Kohno, T., Kohsaka, S., Fukuoka, R., Maekawa, Y., Sano, M., Takatsuki, S., & Fukuda, K. (2017). The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study. International Journal of Cardiology, 228, 977–982. https://doi.org/10.1016/j.ijcard.2016.11.153 PMid:27919528
Morse, A. M., & Bender, E. (2019). Sleep in hospitalized patients. Clocks & Sleep, 1(1), 151–165. https://doi.org/10.3390/clockssleep1010014 PMid:33089161; PMCid:PMC7509688
Nelson, K. L., Davis, J. E., & Corbett, C. F. (2022). Sleep quality: An evolutionary concept analysis. Nursing Forum, 57(1), 144–151. https://doi.org/10.1111/nuf.12647 PMid:34546656
Paruthi, S., Brooks, L. J., D'Ambrosio, C., Hall, W. A., Kotagal, S., Lloyd, R. M., Malow, B. A., Maski, K., Nichols, C., & Quan, S. F. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine, 12(6), 785–786. https://doi.org/10.5664/jcsm.5866 PMid:27250809; PMCid:PMC4878264
Polit, D. F., & Beck, C. T. (2021). Systematic reviews of research evidence. In Nursing Research: Generating and Assessing Evidence for Nursing Practice (11th ed., pp. 655–697). Wolters Kluwer.
Pulak, L. M., & Jensen, L. (2016). Sleep in the intensive care unit: A review. Journal of Intensive Care Medicine, 31(1), 14–23. https://doi.org/10.1177/0885066614552868 PMid:25336453
Ramar, K., Malhotra, R. K., Carden, K. A., Martin, J. L., Abbasi-Feinberg, F., Aurora, R. N., Kapur, V. K., Olson, E. J., Rosen, C. L., & Rowley, J. A. (2021). Sleep is essential to health: An American Academy of Sleep Medicine position statement. Journal of Clinical Sleep Medicine, 17(10), 2115–2119. https://doi.org/10.5664/jcsm.9356 PMid:34569687; PMCid:PMC8516535
Ren, W., Zhang, N., Sun, Y., Pan, L., Hou, Y., Li, D., Huang, X., Liu, K., Sun, H., Sun, Y., Lv, C., Yu, Y., & Han, F. (2023). The REM microarousal and REM duration as the potential indicator in paradoxical insomnia. Sleep Medicine, 109, 110–117. https://doi.org/10.1016/j.sleep.2023.06.011 PMid:37429109
Richards, K. C., O'Sullivan, P. S., & Phillips, R. L. (2000). Measurement of sleep in critically ill patients. Journal of Nursing Measurement, 8(2), 131–144. https://doi.org/10.1891/1061-3749.8.2.131 PMid:11227580
Rodriguez, J. C., Dzierzewski, J. M., & Alessi, C. A. (2015). Sleep problems in the elderly. Medical Clinics, 99(2), 431–439. https://doi.org/10.1017/CBO9781107294967.018
Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307–349. https://doi.org/10.5664/jcsm.6470 PMid:27914609; PMCid:PMC5280088
Sedov, I. D., Cameron, E. E., Madigan, S., & Tomfohr-Madsen, L. M. (2018). Sleep quality during pregnancy: A meta-analysis. Sleep Medicine Reviews, 38, 168–176. https://doi.org/10.1016/j.smrv.2017.06.005 PMid:28736182
Shi, T., Min, M., Sun, C., Zhang, Y., Liang, M., & Sun, Y. (2020). Does insomnia predict a high risk of cancer: A systematic review and meta-analysis of cohort studies. Journal of Sleep Research, 29(1), Article e12876. https://doi.org/10.1111/jsr.12876 PMid:30900797
Smiley, A. (2019). Association of sleep and metabolic syndrome/metabolic syndrome components among participants in Jackson heart study (JHS) and the reasons for geographic and racial differences in stroke (REGARDS) [Doctoral dissertation, Indiana University].
Van Laethem, M., Beckers, D. G. J., Kompier, M. A. J., Kecklund, G., van den Bossche, S. N. J., & Geurts, S. A. E. (2015). Bidirectional relations between work-related stress, sleep quality and perseverative cognition. Journal of Psychosomatic Research, 79(5), 391–398. https://doi.org/10.1016/j.jpsychores.2015.08.004 PMid:26412211
Van Veen, M. M., Lancel, M., Beijer, E., Remmelzwaal, S., & Rutters, F. (2021). The association of sleep quality and aggression: A systematic review and meta-analysis of observational studies. Sleep Medicine Reviews, 59, Article 101500. https://doi.org/10.1016/j.smrv.2021.101500 PMid:33743056
Villamor Ordozgoiti, A., Priu Parra, I., España Salvador, M. C., Torres Valdés, C., Bas Ciutad, M. P., & Ponce Quílez, M. R. (2017). Intervention to reduce the impact of light and noise on sleep in an emergency department observation area. Emergencias: Revista de La Sociedad Española de Medicina de Emergencias, 29(1), 39–42. http://europepmc.org/abstract/MED/28825267 PMid:28825267
Wesselius, H. M., Van Den Ende, E. S., Alsma, J., Ter Maaten, J. C., Schuit, S. C. E., Stassen, P. M., de Vries, O. J., Kaasjager, K. H. A. H., Haak, H. R., & Van Doormaal, F. F. (2018). Quality and quantity of sleep and factors associated with sleep disturbance in hospitalized patients. JAMA Internal Medicine, 178(9), 1201–1208. https://doi.org/10.1001/jamainternmed.2018.2669 PMid:30083755
Wilson, S., Anderson, K., Baldwin, D., Dijk, D.-J., Espie, A., Espie, C., Gringras, P., Krystal, A., Nutt, D., & Selsick, H. (2019). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update. Journal of Psychopharmacology, 33(8), 923–947. https://doi.org/10.1177/0269881119855298 PMid:31223101
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 PMid:24141714
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