Sleep and psychological health during early recovery from critical illness: An observational study

• Published in: Journal of psychosomatic research 2013-12, Vol.75 (6), p.539-545
• Main Authors: McKinley, Sharon, Fien, Mary, Elliott, Rosalind, Elliott, Doug
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anxiety - etiology; Critical illness; Critical Illness - psychology; Female; Humans; Intensive care; Intensive Care Units; Male; Mental Health; Middle Aged; Patient Discharge; Psychiatry; Psychological health; Quality of Life; Recovery; Sleep; Survivors
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2013.09.007

Abstract Introduction Intensive care patients often report sleep disruption in ICU and during recovery from critical illness. Objectives To assess: (i) patients' self-reported sleep quality in ICU, on the hospital ward after transfer from ICU and two and six months after hospital discharge; (ii) whether patients who report sleep disruption in ICU continue to report sleep disruption in recovery and (iii) whether prehospital insomnia, experiences in intensive care, quality of life and psychological health are associated with sleep disruption six months after hospital discharge. Methods Patients completed self-report measures on sleep quality at five time points: prior to hospitalization, in ICU, the hospital ward, two months and six months after hospital discharge, their intensive care experiences two months after discharge and psychological health and quality of life six months after discharge. Results Patients (n = 222) were aged (mean ± SD) 57.2 ± 17.2 years, 35% female, had mean ICU stay of 5 ± 6 days and BMI of 26 ± 5. Over half the participants (57%) reported poor sleep at six months; for 10% this was at all time points after ICU admission. Prehospitalization insomnia (p = .0005), sleep quality on the ward (p = .006), anxiety (p = .002), and mental (p = .0005) and physical health (p = .0005) were independently associated with poorer sleep quality in survivors six months after ICU treatment. Conclusions Sleep is a significant issue for more than half of survivors 6 months after ICU treatment. Some influencing factors, such as hospital sleep quality, anxiety, physical health and mental health, are potentially modifiable and should be targeted in recovery programs.