الفهرس 
Sleep overviewOnly 14 pages are availabe for public view
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Abstract
Sleep, comprises approximately one third of the human life. It is a state of unconsciousness in which the individual can be awakened by sensorial or other stimuli. Sleep provides mental and physical restructuring of energy storage. Sleep in critically ill patients is characterized by frequent disruptions, changes in the circadian rhythm, and poor quality, along with a reduction in the deep stages. Such sleep disturbances seem to be due to factors related to the ICU itself, such as care routines and environmental stimuli; factors intrinsic to the patients and the acute nature of their condition; and factors related to the treatments administered. As a result, patients exhibit symptoms such as difficulty with sleep initiation and fragmentation, and early morning awakenings (Cicek, et al., 2014).
The aim of the study is to:
Assess the factors affecting sleep disturbances among patients in critical care units.
Research question:
What are the factors affecting sleep disturbances among patients in critical care units? Research Design:
A descriptive design will be used to conduct the study.
Setting:
The study was conducted in intensive care units at ELdermerdash hospital one of the Ain Shams University Hospitals
Subjects:
A purposive sample of 70 patients at intensive care units at ELdermerdash hospital one of the Ain Shams University Hospitals
Tools used to accomplish the aim of this study:
Tools of data collection:
Two tools were used in the current study as the following:-
Tool I:
An interviewing questionnaire sheet consists of two parts :
Part I:
Socio demographic data, Patient medical history, and Sleep assessment questionnaire. Part II:
Factors affecting sleep by patient own expressions after admission to ICU, Environmental factors, Noise related factors, and Nursing intervention related factors
Tool II:
The Groningen’s Sleep Quality Scale: was developed by Hajonides et al. (2003) to measure the subjective quality of sleep the night before
Results:
The results of the study showed that:
Patients who rate their sleep poor before admission excluded from the study.(94.3%) of patients complained of difficulty to fall in sleep at night and
More than third (40.6 %) of patients waked more than three times , (65.7% )of patients slept between 3to 6 hours,
About two thirds (65.7%) of patients felt tired and about three quarters (71.4%) felt sleepy during the day.
More than three quarters (80%) of patients complained of noise environment, and majority (82.9 %) from lights, There was a statistically significance relation between patients’ gender and total factors(P-0.045*)
There a statistically significance relation between patients’ co-morbidity and total factor (P-0.036*): the patients who complained of more one disease more affected than others.
There was highly significance (P-<0.001*) between GSQS and reasons of hospitalization but operative patients scored higher than non operative patients
There was significant relation (P-0.021*) between previous experience of hospitalization and GSQS, the patients were first time admission scored higher
There was a positive correlation between total factor and patient related factors that disturbing sleep in the critical care units (P< 0.001*).
Conclusion
Based on findings of the current study, it can be concluded that:
There was difference between the quality of sleep pattern before and after hospitalization, about two thirds of studied patients were not satisfied about their sleep in ICU after admission. The majority of patients often had difficulty in falling asleep at night and took an hour or more to fall asleep, and this is shown by their complaints about waking up during the night and not having a restorative sleep related to the ICU environment is not favorable for sleep. Our study illustrated that sleep disturbance is more likely to happen due to intrinsic and extrinsic factors that affect hospitalized patients in different ways according to individual circumstances, which can include the patient’s personal illness previous experiences, concerns, and fears, whereas extrinsic factor as noises, lights, bad odors, and medical staff interventions.
Recommendation
Create a suitable ICU environment that should decrease noises and lights and maintain suitable temperature during night time hours to promote sleep.
Minimize staff conversation, alarms during the quiet night time hours and they should keep their telephone silent.
Provide educational programs for nurses about the importance of sleep to critically ill patients and the effect of sleep disturbance on patients‘ health.