Sleep quality assessment in intensive care: actigraphy vs. Richards-Campbell sleep questionnaire

Hana Locihová; Karel Axmann; Katarína Žiaková; Dagmar Šerková; Simona Černochová

doi:10.5935/1984-0063.20190145

Sleep quality assessment in intensive care: actigraphy vs. Richards-Campbell sleep questionnaire

Sleep Sci. 2020 Oct-Dec;13(4):235-241. doi: 10.5935/1984-0063.20190145.

Authors

Hana Locihová^{1

2}, Karel Axmann^{3

4}, Katarína Žiaková¹, Dagmar Šerková^{5

6}, Simona Černochová⁶

Affiliations

¹ Department of Nursing, Jesseniuss Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia.
² AGEL Educational and Research Institute (VAVIA), Prostějov, Czech Republic.
³ Department of Anaesthesiology and Resuscitation and Intensive Care Medicine, University Hospital Olomouc.
⁴ Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
⁵ Department of Nursing and Midwifery, Ostrava, University of Ostrava, Faculty of Medicine, Czech Republic.
⁶ Interdisciplinary Intensive Care Unit, Hospital Nový Jičín, Czech Republic.

Abstract

Introduction: It has been repeatedly shown that sleep of intensive care unit (ICU) patients is fragmented and its architecture is impaired. As sleep disorders have numerous negative effects on the organism, there have been efforts to implement sleep-promoting strategies into practice. When comparing the effectiveness of such measures, sleep quality assessment itself is a considerable problem.

Objective: The study aimed to assess the quality and quantity of night sleep in ICU patients simultaneously with actigraphy (ACT) and the Richards-Campbell Sleep Questionnaire (RCSQ). The secondary goals were to test the performance and effectiveness of the above methods and to verify correlations between selected RCSQ items and actigraph parameters.

Methods: A single-center prospective observational study (20 patients staying in a Interdisciplinary Intensive Care Unit). The quality of sleep was assessed using a Czech version of the RCSQ and ACT. The obtained data were analyzed and their dependence or correlations were veriﬁed by selected statistical tests.

Results: The mean RCSQ score was 47.6 (SD 24.4). The worst results were found for sleep latency (44.4; SD 31.2); the best results were for sleep quality (50.2; SD 29.4). The mean sleep effciency measured with ACT reached 86.6% (SD 9.2); the mean number of awakenings per night was 17.1 (SD 8.5). The RCSQ total parameter with a cutoff of 50 (RCSQ total = 50 good sleep / RCSQ total < 50 poor sleep) was shown to be suitable for discrimination of subjectively perceived sleep quality in ICU patients. However, the study failed to show statistically signiﬁcant relations between subjectively perceived sleep quality (RCSQ) and ACT measurements.

Conclusion: The RCSQ appears to be a suitable instrument for assessing night sleep quality in ICU patients. On the other hand, the study showed a very low level of agreement between subjective sleep quality assessment and objective ACT measurements. The main drawback of ACT is low reliability of obtained data. Further research is needed to determine its role in sleep quality assessment in the ICU setting.

Keywords: Actigraphy; Intensive Care Unit; Richards-Campbell Sleep Questionnaire; Sleep.