Sensitivity and specificity of proposed Richards-Campbell Sleep Questionnaire cut-off scores for good quality sleep during an ICU stay.

Abstract

The 5-visual analogue scale Richards-Campbell Sleep Questionnaire subjective sleep measure is widely used in intensive care. A cut-off score indicative of good quality sleep has not been established and is required to guide the categorisation of individual patient and unit wide sleep quality. The aim was to determine the global Richards-Campbell Sleep Questionnaire cut-off score for good to very good sleep during an intensive care unit stay in non-ventilated patients. The study was a secondary (cohort) retrospective analysis of patient self-report data (n=32) from an interventional study testing a sleep promotion bundle. The Standards for Reporting Diagnostic Accuracy studies statement were used to report the study. The study was conducted in two mixed adult 12 and 20-bed ICUs of a tertiary referral hospital in a metropolitan area. In the morning, eligible patients were administered the Richards-Campbell Sleep Questionnaire together with a 5-category item Likert scale in which patients rated their nocturnal sleep quality as 'very poor', 'poor', 'fair', 'good' and 'very good'. Receiver Operator Curve analysis was performed. Thirty-seven per cent (n=32) of the total sample of 84 adult intensive care patients were females. The median age was 61.5 (51, 72) years. Self-reported median global Richards-Campbell Sleep Questionnaire score was 54.4 (30.1, 77.1) mm. A global score of ≥63.4mm was the optimal cut-off for self-reported 'good sleep' (sensitivity: 87%, specificity: 81% and area under the curve: 0.896). Although the study requires replication in ventilated patients and other ICU settings, the cut-off score (63mm) could be used to guide the categorisation of individual patient and unit wide sleep quality.