Development and daily use of a numeric rating score to assess sleep quality in ICU patients

Abstract

PurposeInsufficient sleep burdens critically ill patients, optimizing sleep may enhance patient's outcomes. Current assessment methods may unnecessary burden patients. Therefore, a single numeric rating score was validated for sleep assessment. Materials and methodsFirst, two cross-sectional measurements on two separate days, from cooperative patients from 19 centers assessed their sleep sufficiency, the numeric rating score (NRS) and the Richards Campbell Sleep Questionnaire (RCSQ). Assessments were compared using a Bland Altman plot. A NRS cut-off was determined using regression analysis. Second, daily sleep assessment was implemented and monitored single center for a year. ResultsMulticenter, 194 patients assessed sleep quality, of which 53% was rated as sufficient. Mean (±SD) difference between RCSQ and NRS-Sleep using Bland-Altman analysis was 0.25 (±1.21, 95% limits of agreement −2.12 to 2.62). The optimal cut-off was >5. Single center, 1603 patients ranked 4532 ICU nights of sleep, of which 71% was sufficient; median NRS was 6 [IQR 5–7]. ConclusionsA single numeric rating score for sleep is interchangeable for the RCSQ score for assessment of sleep quality. Optimal cut-off is >5. Use of a numeric rating score for sleep is a practical way to evaluate and monitor sleep as perceived by patients in daily ICU practice.