Sleep Disturbance Factors Research Articles

Patient-nurse agreement on inpatient sleep and sleep disturbing factors

BackgroundSleep is vital for recovery during hospital stay. Many sleep-promoting interventions have been investigated in the past. Nurses seem to overestimate their patients sleep and their perspective is needed for these interventions to be successfully implemented. ObjectivesTo assess the patient's and nurse's agreement on the patient's sleep and factors disturbing sleep. MethodsThe instruments used included 1) five Richard-Campbell Sleep Questionnaire (RCSQ) items plus a rating of nighttime noise and 2) the Consensus Sleep Diary (CSD). The mean of the five RCSQ items comprised a total score, which reflects sleep quality. Once a week, unannounced, nurses and patients were asked to fill in questionnaires concerning last night's sleep. Neither nurses nor patients knew the others' ratings. Patient-nurse agreement was evaluated by using median differences and Bland-Altman plots. Reliability was evaluated by using intraclass correlation coefficients. ResultsFifty-five paired patient-nurse assessments have been completed. For all RCSQ subitems, nurses' scores were higher (indicating “better” sleep) than patients’ scores, with a significantly higher rating for sleep depth (median [IQR], 70 [40] vs 50 [40], P = .012). The Bland-Altman plots for the RSCQ Total Score (r = 0.0593, P = .008) revealed a significant amount of variation (bias). The intra-class correlation coefficient (ICC) indicated poor reliability for all 7 measures (range −0.278 – 0.435). Nurses were relatively overestimating their own role in causing sleep disturbances and underestimating patient-related factors. ConclusionsNurses tend to overestimate patients’ sleep quality as well as their own role in causing sleep disturbances.

A Scoping Review and Conceptual Framework Examining the Role of Sleep Disturbance in Financial Exploitation in Older Adults.

Sleep disturbances and financial exploitation have both been linked to impaired cognitive ability, loneliness, and depressed mood in older adults, suggesting a potential role of sleep disturbances in increasing vulnerability to financial exploitation. We sought to identify evidence linking sleep disturbances to financial exploitation. We conducted a systematic search of MEDLINE, PubMed Central, and National Center for Biotechnology Information Bookshelf for relevant published articles on sleep and financial exploitation. Three studies examining both sleep and financial exploitation were identified. None of the studies explored sleep disturbances as a cause of financial exploitation. More work needs to be done to examine the role of sleep disturbances in financial exploitation. We propose a conceptual framework for identifying possible associations among sleep disturbance, biopsychosocial, and decision-related situational factors to guide further exploration of relationships between sleep and financial exploitation.

Sleep quality and sleep disturbances in Chinese pregnant women: a multicenter cross-sectional study

Objective: This study aims to investigate the sleep quality of pregnant women in Xuhui District, Shanghai, and the related factors of sleep disturbances during pregnancy. Methods: From February 2019 to February 2021, we used online integrated sleep questionnaire (including PSQI, BQ, ESS, AIS) in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, The International Peace Maternity and Child Health Hospitals of China Welfare Institution, and Shanghai Eighth People's Hospital, to investigate the sleep quality across pregnancy. We also collected maternal physical examination results, childbearing history, sociodemographic, and other clinical data. The prevalences and related factors of various sleep disturbances in pregnant women were analyzed, including insufficient/excessive nighttime sleep, low sleep efficiency, difficulty falling asleep, poor sleep quality, insomnia, daytime sleepiness, and high risk of sleep-disordered breathing (SDB). Results: This study includes 1 898 cases in the first trimester (T1), 3 099 cases in the second trimester (T2), and 1 539 cases in the third trimester (T3). Poor sleep quality (38.6%), daytime sleepiness (mild 41.9%, moderate 17.7%, severe 2.1%), and suspicious insomnia (32.3%) are most prevalent among women in T1 (P<0.01). In comparison, short sleep time (2.7%), long sleep time (8.6%), difficulty falling asleep (12.2%), poor sleep efficiency (35.4%), very poor sleep quality (6.7%), clinical insomnia (21.8%), and high-risk SDB (6.4%) are most prevalent among women in T3 (P<0.05). During pregnancy, late gestation (OR=1.016, 95%CI: 1.006-1.025) and multiple induced/drug abortions (OR=1.329, 95%CI: 1.043-1.692) are risk factors for poor sleep quality (PSQI>5), while multiple full-term deliveries (OR=0.800, 95%CI: 0.675-0.949) is its protective factor. Advanced maternal age (OR=0.976, 95%CI: 0.956-0.997), multiple full-term deliveries (OR=0.808, 95%CI: 0.680-0.959), late gestation (OR=0.983, 95%CI: 0.974-0.992) and hypertension (OR=0.572, 95%CI: 0.401-0.814) are protective factors for daytime sleepiness (ESS>6). The high-risk pregnancy category (OR=9.312, 95%CI: 1.156-74.978) is a risk factor for insomnia (AIS≥4), while multiple full-term deliveries (OR=0.815, 95%CI: 0.691-0.961) is its protective factor. High BMI (OR=1.334, 95%CI: 1.270-1.402) and hypertension (OR=4.427, 95%CI: 2.539-7.719) are risk factors for high-risk SDB in pregnant women. Conclusions: The prevalences of various sleep disturbances are high throughout pregnancy. Noticeably, symptoms of maternal SDB develop along with pregnancy. Different types of sleep disturbances are associated with different factors. Women of high-risk pregnancy category, in late gestation, with high BMI, hypertension, a history of induced/drug abortion, or without a history of full-term delivery can be at high risk of sleep disturbances during pregnancy.

Sleep, depression, and anxiety in family caregivers of nasopharyngeal carcinoma patients before therapy

Sleep disturbance, anxiety, and depression are frequently observed in cancer patients. There have fewer studies about the sleep and emotional status of nasopharyngeal carcinoma (NPC) patient family caregivers (FCs) before treatment. We explored the sleep, depression, and anxiety in NPC patient FCs before therapy, compared sleep quality between caregivers with and without depression and anxiety, and examined and related factors of sleep disturbance in FCs of NPC patients before therapy. FC-patient dyads included from two centers were 92 in total. The proportions of poor sleep, anxiety, and depression in NPC patient FCs were 45.7%, 43.5%, and 54.3%, respectively. FCs with anxiety or depression were more inclined to report decreased sleep quality. Depressed caregivers were 11.11 times more to be poor quality sleep before patients treatment (OR = 11.11, 95%; CI = 2.94–42.05). NPC patient FCs before treatment are at high risk of sleep disturbances, depression, and anxiety, especially those already experiencing anxiety and depression symptoms.

Risk Factors of Sleep Disturbance in Older Adults With Dementia: An Actigraphy-Based Validation Study

Sleep disturbance is a common and significant symptom experienced by older adults with dementia. Early detection and timely treatment of sleep disturbance are critical to prevent adverse consequences including decreased quality of life for persons with dementia and increased caregiver burden. While direct observations and sleep diaries are often unreliable, actigraphy is a cost-effective method in measuring sleep problems in older adults with dementia and provides reliable and rich sleep data. Therefore, this study aimed to examine sleep disturbance objectively measured by actigraphy and its risk factors in community-dwelling older adults with dementia in Korea. This is a prospective study consisting of a two-wave dataset. The model was fitted using Wave 1 data (n=151) and then validated using Wave 2 data (n=59). Independent variables were demographics, cognitive and physical function, depressive symptoms, physical activity level, and neuropsychiatric symptoms measured by Neuropsychiatric Inventory(NPI), and clinical factors including dementia type, sedative use, and comorbidities. Sleep disturbance was defined as less than six nighttime sleep hours and sleep efficacy less than 75%. Using the Youden’s Index, the sample was dichotomized into sleep disturbance group (n=83) and sound sleep group (n=68). The results of the generalized linear mixed model showed that the risk factors for sleep disturbance included vascular dementia, age, step count, and having three neuropsychiatric symptoms (i.e., delusions, depression, and disinhibition). Individuals with dementia at risk for sleep disturbance should be identified to prioritize early prevention strategies and individualized interventions. Particularly, management of delusion, depression, disinhibition is critical in preventing disturbed sleep.

Co-occurrence of sleeping difficulties with urbanization and food choice in female university students.

Introduction: Sleep is a basic and essential need of human beings, large number of sleep related problems are demonstrated in all age groups with different pro-moting factor( s), these may be biological, social, economical or environmental. Literature is scanty to identify co factors of sleep disturbances in apparently healthy females.Objective: To analyze association of sleep disorders in females with rural/ urban settings of living and certain dietary habits.Methodology: A cross sectional /survey-based study was performed in University of Sindh Jamshoro. The sample size (n) was 520.The data comprised of females aged between 18 -26 years. Pittsburgh Sleep Quality Index (PSQI) was employed to assess sleep quality among the participants along with self-structured question-naire which was used for other variables such as consumption of junk food and its frequency of intake and breakfast intake.Results: Out of 520 participants, 310 (60%) were living in urban areas shows com-paratively higher frequency of poor sleep (n=262,50.5%; p=0.01-odd ratio=2.18) than those who were living in rural setups. Poor sleep was also observed in junk food eaters (n=304, 58%) however no association was observed in pattern of breakfast with sleep.Conclusion: The study concluded the prevalence of poor sleep was found more in urban female dwellers.Keywords: sleep, rural, urban, junk food, breakfast, Pittsburgh Sleep Quality Index (PSQI).

Cardiovascular disease prevention: Risk factor modification at the heart of the matter

Cardiovascular disease prevention: Risk factor modification at the heart of the matter

Sleep disturbances and correlates among a sample of preschool children in rural China.

This study aimed to explore the prevalence of sleep disturbances among preschool children in rural areas of China and identify the underlying associated factors. A cross-sectional study was conducted in rural areas of Anhui Province, China, from September 2019 to January 2020. The caregivers of children from 26 kindergartens completed the demographic questionnaire, the Children's Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), the Self-rating Anxiety Scale (SAS), and the adapted Identification and Management of Feeding Difficulties (IMFeD) tool. One-way analysis of variance, independent-samples t-test, and hierarchical multiple linear regression were conducted to explore the potential influencing factors of sleep disturbances in preschool children. For the specific sleep disturbances based on each subscale of the CSHQ, bedtime resistance (54.9%) and sleep anxiety (47.9%) were the most common types of sleep disturbances, followed by daytime sleepiness (21.3%), sleep duration (20.8%), parasomnias (16.5%), sleep-onset delay (12.6%), night wakings (12.2%) and sleep-disordered breathing (10.3%). The ages of children, children's emotional/behavioral problems, children's feeding difficulties, inconsistent parenting attitudes of parents, poor parenting styles, non-parent caregivers, and caregiver anxiety contributed significantly to the CSHQ total score, accounting for approximately 27.1% (R2 = 0.271) of the variance. Our study indicates that the prevalence of sleep disturbances among preschool children in rural areas of China is quite high. Furthermore, the potential risk factors are complicated, including factors related to both children and their caregivers.

Mental Health in Hospitalised COVID 19 Patients in Quarantine During Second Wave in a South Indian Private Teaching Hospital.

BackgroundCovid 19 lockdown measures were taken all of a sudden during the devastating second wave in India, when there was a considerable loss and suffering in the country. The coronavirus disease 2019 (COVID 19) pandemic has led to unprecedented hazards to mental well-being globally.PurposeTo assess the prevalence and evaluate risk factors of depression, insomnia or sleep disturbances and suicidal ideation among covid 19 positive patients admitted in covid wards with mild-to-moderate disease.Materials and MethodsA total of 635 hospitalised patients who were covid-19 positive were requested to fill an online quality of life pre-validated questionnaire comprising of 4 sections – the sociodemographic information section, health care assessment related to depression symptoms, insomnia assessment and assessment of suicidal ideation. The survey comprised of pre-validated questions on sociodemographics, knowledge of covid 19, fear of covid 19, insomnia, feeling of sadness, depression, feeling of rejection and suicidal ideation among the covid 19 positive inpatients in quarantine due to mild or moderate covid 19 disease.ResultsThe prevalence of depression and insomnia or sleep disturbances after being diagnosed as covid 19 positive and hospitalized was nearly 40% and 28.8%, respectively, among the inpatients. Depression was significantly observed in female group (p < 0.001), unmarried or separated individuals (p < 0.001), housewives (p < 0.001) and patients with comorbidities (p < 0.001). Insomnia was more likely to be present in elderly covid positive patients (p < 0.001) and separated or divorced group of participants (p < 0.001). The prevalence of suicidal ideation was 5% of the total covid 19 positive patients participated in this study, and it was significantly observed among separated or divorced patients, cancer patients, patients from suburban residence and among graduates (p < 0.001).ConclusionCovid 19 is associated with major psychological impact among the patients suffering from thus warrants counselling.

Comparison of sleep quality before and after chemotherapy in locally advanced non-small-cell lung cancer patients

Background Outcome of sleep disturbances in lung cancer patients before and after treatment is not much reported. Their intensity and their correlation to quality of life or to humor disturbances were not widely studied. The aim of this study was to report precisely sleep disturbances in advanced stage lung cancer patients, their outcome after chemotherapy and/or radiotherapy, and their correlation to anxiodepressive humor. Patients and methods It was a prospective study including 64 patients with stage 3 or 4 non-small-cell lung cancer. Patients answered the Tunisian dialectal version of the following questionnaires: Pittsburgh sleep quality index and hospital anxiety depression scale in order to evaluate, respectively, the sleep quality and anxiodepressive troubles. The questionnaires took place before chemotherapy and then were repeated after chemotherapy was over. Results The mean age was 62.9 years. All patients were active smokers. Before chemotherapy, there were 10 (15%) patients with poor sleep quality. Most frequent complaints were daily sleepiness (70%) and nocturnal arousals (100%). Sixteen (25%) patients had depressive humor. Depression was statistically more frequent among patients with poor sleep quality (80 vs 15%, P&lt;0.001). After chemotherapy, the mean Pittsburgh sleep quality index score increased from 2.9 to 5.4 and 45% of all patients had poor sleep quality. Most frequent complaints were extension of sleep latency (69%), daily sleepiness (98%), and nocturnal arousals (100%). After chemotherapy, depressive humor was reported in 34.3% of all patients, with higher prevalence among patients with poor sleep quality (58 vs 14%, P&lt;0.001). Anxious humor was reported in 17% of all patients. A higher prevalence was correlated with poor sleep quality (31 vs 6%, P&lt;0.001). The predicting factors of sleep disturbance according to statistical univariate analysis were delayed diagnosis confirmation (P=0.05), delayed start of treatment (P&lt;0.001), and anxious (P=0.001) or depressive humor (P=0.001). Multivariate analysis confirmed the correlation of sleep disturbance to delayed diagnosis confirmation and treatment onset. Conclusion This study insisted on the persistence and potential intensity worsening of sleep disturbances in advanced stage non-small-cell lung cancer patients. The authors, hereby, reported a statistical correlation between sleep quality and humor quality in patients.

Frequency and Risk Factors of Sleep Disturbances in Patients With Prostate Cancer Assigned to Local or Loco-regional Radiotherapy

Many patients with prostate cancer receive definitive or adjuvant radiotherapy. This study aimed to identify the frequency of sleep disturbances and corresponding risk factors prior to radiation treatment. Data of 48 patients assigned to local or loco-regional irradiation for prostate cancer were retrospectively analyzed for pre-radiotherapy sleep disturbances. Fifteen characteristics were analyzed including age, performance status, comorbidity, history of previous malignancy, distress score, (emotional, physical or practical) problems, prostate-specific antigen, primary tumor stage, Gleason-score, upfront androgen deprivation therapy (ADT), treatment volume, brachytherapy, and COVID-19 pandemic. Pre-radiotherapy sleep disturbances were reported by 20.8% of patients and significantly associated with distress scores ≥4 (p<0.0001) and ≥3 physical problems (p=0.0001). Trends were found for Karnofsky performance score ≤80 (p=0.095), Gleason score 7b-9 (p=0.079), and ADT (p=0.067). Pre-radiotherapy sleep disturbances were less common in prostate cancer patients than in other cancer patients. Risk factors were identified that can help identify patients requiring psychological support prior to radiotherapy.

Risk Factors for Sleep Disturbances in Patients Scheduled for Radiotherapy of Head-and-Neck Cancer.

Many patients with head-and-neck cancer are scheduled for irradiation. This study was performed to determine the frequency of and risk factors for pre-radiotherapy sleep disturbances in these patients. A total of 103 patients with head-and-neck cancer scheduled for radiotherapy were included in this retrospective study. Eighteen characteristics were evaluated including timing of start of radiotherapy relative to COVID-19 pandemic; age; gender; Karnofsky performance score; Charlson comorbidity index; history of another malignancy; family history of malignancy; distress score; number of emotional, physical or practical problems; request for psychological support; tumor site and stage; upfront surgery; planned chemotherapy; and brachytherapy boost. The frequency of pre-radiotherapy sleep disturbances was 42.7%. This was significantly associated with age ≤63 years (p=0.049), Karnofsky performance score ≤80 (p=0.002), Charlson comorbidity index ≥3 (p=0.005), history of another malignancy (p=0.012), emotional (p=0.001) or physical (p<0.001) problems, and request for psychological support (p=0.002). Sleep disturbances were frequent in patients assigned to radiotherapy of head-and-neck cancer. Recognizing risk factors for sleep disturbance helps identify patients requiring psychological support.

Sleep disorders in Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting both the central and peripheral nervous system. The median survival rate for ALS patients after symptom onset is 2.5 to 3.5 years and after diagnosis of ALS is about 1.5 to 2.5 years. Patients with ALS can have a wide spectrum of sleep disorders including but not limited to insomnia, sleep related breathing disorders, parasomnias, obstructive sleep apnea (OSA) and nocturnal hypoventilation (NH). Sleep-related breathing disorders substantially increase both morbidity and mortality in ALS patients. In this review, we have discussed the ALS motor symptoms, sleep-related breathing disorders, behavioral abnormalities and sleep disturbing factors which impair the health-related quality of life.

Sleep disturbance in primary brain tumor: prevalence, risk factors, and patient preferences.

PurposePrimary brain tumor (PBT) patients report sleep disturbance due to their disease and treatment, yet few studies have utilized validated measures to understand the extent of patients’ concerns and preferences for treatment. The purpose of this quality improvement project was to determine the prevalence and associated risk factors of sleep disturbance among PBT patients in our clinic and to evaluate interest in treatment for sleep disturbance.MethodsPBT patients completed validated measures of sleep disturbance and health during routine neuro-oncology visits. Patients also reported on sleep-related symptom management and their preferences for pharmacological and/or behavioral treatment.ResultsSleep disturbance was common, with 61.5% of PBT patients (N = 119; Mage = 52.60 years; 50% male) reporting poor sleep quality and 21.5% endorsing symptoms of insomnia. Insomnia could be explained by increased fatigue and corticosteroid use; sleep quality could be explained by fatigue. Patients in our clinic with higher grade tumors, significant sleep disturbance, of minority racial/ethnic status, and those not already taking sleep medications were more likely to report their symptoms and were not well-addressed by their medical team. Patients indicated a similar interest in pharmacological and behavioral treatment, warranting the availability of both in our clinic.ConclusionsFindings indicate a high prevalence of sleep disturbance in PBT patients, highlighting the need for increased screening, monitoring, and treatment in our neuro-oncology clinic. Future research would benefit from assessing the efficacy of behavioral treatments for sleep disturbance in this population.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-021-06476-3.

Sleep disturbance among frontline nurses during the COVID-19 pandemic

The main objective of this study is to assess the prevalence of sleep disturbance and related psychological factors (stress, anxiety and depression) among frontline nurses in Oman during the COVID-19 pandemic. A cross-sectional and descriptive correlational design using Qualtrics® software was used in this research. Data were collected using the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS). Logistic regression was performed to identify factors associated with poor sleep quality. Of the 987 frontline nurses who participated, 58.8% (n = 580) reported poor sleep quality. In an examination of PSQI components the mean sleep duration was 7.04 (SD = 1.59) hours per night, and the sleep latency mean was 38.18 min (SD = 31.81). Poor sleep (p < .05) was significantly associated with age, marital status, years of experience, comorbidity, and whether family members or relatives were suspected or confirmed with having COVID-19. Logistic regression showed that poor quality of sleep was significantly associated with stress, anxiety and depression symptoms. Sleep disturbance is a significant problem for frontline nurses working in Oman during the COVID-19 pandemic. Appropriate interventions to maintain the health conditions and reduce sleep disturbance among frontline nurses are needed in order to help support nurses’ work during contagious disease outbreaks. These can be implemented through online workshops and training to enhance nurses’ responses to the pandemic or to any further disease outbreaks.

Is it Noise? Factors Linked With Sleep Interruption in Hospitalized Patients.

The aim of this study was to explore the perceived quality of sleep and sleep disturbances in hospitalized patients. A prospective descriptive, exploratory, cross-sectional study was conducted at a 172-bed community hospital in Northeast Ohio. A convenient sample of 100 hospitalized patients was recruited from medical/surgical, progressive care, and intensive care units. Participants used the Richards-Campbell Sleep Questionnaire to report sleep. A quality of sleep assessment survey was used to collect information regarding 17 factors leading to decreased quality of sleep. Mean sleep score was 47.92 for each question regarding sleep depth, latency, awakenings, time spent awake, and overall sleep quality. Pearson's correlation showed a significantly positive correlation between measure of noise and sleep score. Five environmental factors were identified as most disruptive to sleep: pain, laboratory draws, staff, blood pressure checks, and intravenous alarms. The positive correlation between sleeping well and higher noise levels is noteworthy. Raising awareness about the importance of sleep in the hospital setting and introducing interventions to promote a quiet environment and minimize sleep-disturbing factors may increase patient satisfaction scores and improve healing.

Sleep improvement intervention and its effect on patients' sleep on the ward.

The aim of the study was to investigate how the sleep improvement interventions developed for the wards were associated with patients' sleep. The objective was to promote patients' sleep. The quality of sleep is vital for patients' health and recovery from illness. However, patients generally sleep poorly during hospitalisation. Sleep-disturbing factors are connected to the hospital environment, patients' physical illness, emotional state and the activities of the staff. Many sleep-disturbing factors can be influenced by appropriate nursing interventions. A two-group intervention study including the development of nursing interventions aimed at supporting patients' sleep. One group received a sleep promotion intervention and the other received standard care. Both groups evaluated their sleep in the morning. A survey of participants' sleep evaluations was collected with the five-item Richards-Campbell Sleep Questionnaire. The data were analysed statistically. The STROBE checklist was used to report the study. From the participants' perspective, sleep was better in the intervention group, even though statistically significantly only among men. The pain intensity correlated with sleep quality. The number of patients in the room or whether participants had had an operation had no effect on their sleep evaluations. Interventions targeted at supporting and promoting the sleep quality of hospital inpatients may be effective. They should be developed in collaboration with patients and nurses. Several nursing interventions can be proposed to promote better sleep among patients; however, more research is needed to confirm the results. Sleep promotion should include both standardised protocols and individualised sleep support. Investing in nursing interventions to promote patients' sleep is important. Patients' individual sleep-related needs should be part of their care plan. Training programmes that support nurses' knowledge and skills of patients' sleep promotion should be part of nursing education in healthcare organisations.

What happens after menopause? (WHAM): A prospective controlled study of sleep quality up to 12 months after premenopausal risk-reducing salpingo-oophorectomy

ObjectiveSleep difficulties impair function and increase the risk of depression at menopause and premenopausal oophorectomy may further worsen sleep. However, prospective data are limited, and it remains uncertain whether Hormone Therapy (HT) improves sleep. This prospective observational study measured sleep quality before and up to 12 months after risk-reducing salpingo-oophorectomy (RRSO) compared to a similar age comparison group who retained their ovaries. MethodsNinety-five premenopausal women undergoing RRSO and 99 comparisons were evaluated over a 12-month period using the Pittsburgh Sleep Quality Index (PSQI). ResultsAlmost half reported poor sleep quality at baseline. Overall sleep quality was not affected by RRSO until 12 months (p = 0.007). However, sleep disturbance increased by 3 months and remained significantly elevated at 12 months (p < 0.001). Trajectory analysis demonstrated that 41% had increased sleep disturbance after RRSO which persisted in 17.9%. Risk factors for sleep disturbance included severe vasomotor symptoms, obesity and smoking. Around 60% initiated HT after RRSO. Sleep quality was significantly better in HT users vs non users (p = 0.020) but HT did not restore sleep quality to baseline levels. ConclusionsOverall sleep quality is not affected by RRSO, but new onset sleep disturbance is common, particularly in those with severe vasomotor symptoms. Clinicians should be alert to new-onset sleep disturbance and the potential for HT to improve sleep quality.

Nursing management of anxiety and sleep disorders in patients hospitalized in a cardiac intensive care unit

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac intensive care unit is an environment that induces a high rate of stress, anxiety and sleep disorders in hospitalized patients. All these elements can create an obstacle in the continuity of care and increase cardiovascular risk. Purpose The purpose of our study was to evaluate the anxiety and sleep disorders in patients admitted to the ICUU and to evaluate nurses’ behavior to these disorders. Materials and methods We conducted a descriptive, transversal, observational, prospective study in the cardiology department of Habib Thameur Hospital, which included 37 patients admitted to the ICU and 11 nurses practicing in the department. A questionnaire including two validated scales (HADS-A for anxiety and RCSQ for sleep) was submitted to patients and a self-questionnaire was administered to nurses. Results Patients mean age was 61.24 ± 13.41 years with a sex ratio of 2.36. Eight patients (22%) admitted to the ICU had anxiety disorder. In univariate analysis, female gender and mean hospital stay were significantly associated with anxiety among patients admitted to the ICU. In multivariate analysis, female gender was the only independent factor associated with anxiety at ICU hospitalization (relative risk = 3, 95% confidence interval 2.25-3.37, p = 0.005). Seventeen patients (40%) were afraid of death. The majority of patients (92%, n = 34) felt safe with the health care team. Most patients (92%, n = 34) responded to their visitors (through the window), 97% of whom were family members. Seven patients (19%) had poor sleep. The item with the lowest average was the quality of sleep (53.86 ± 15.65). In univariate analysis, urban living and the average number of sleep hours were significantly associated with poor sleep. Surveillance of vital signs, noise and monitor alarms were the main factors of sleep disturbance. Eleven nurses were included in our study. Seven nurses considered the management of anxiety as not important, and six answered that the management of sleep disorders was not important. The most used medication by nurses to relieve both symptoms was Hydroxyzine tablets. The most common non-medical way to relieve anxiety was privacy. The most common non-medication way to improve sleep was brightness reduction. Conclusion Our study shows that despite the prevalence of anxiety and sleep disorders in patients admitted to the ICU, their care by nurses was not adequate. Specific training on assessment and coping with these disorders could improve nursing care.

Incidence of and Factors Associated with New-Onset Insomnia Among Lebanese Hospitalised Patients: A single-centre study.

ObjectivesThis study aimed to determine the incidence and post-discharge resolution of new-onset insomnia in hospitalised patients with no previous history of insomnia, as well as to define major correlates of in-hospital insomnia.MethodsThis prospective observational study was conducted between November 2019 and January 2020 at a tertiary care centre in Lebanon. All hospitalised patients >18 years of age with no history of insomnia were screened for new-onset insomnia using the Insomnia Severity Index (ISI) scale. Subsequently, patients were re-assessed two weeks after discharge to determine insomnia resolution.ResultsA total of 75 patients were included in the study. Of these, nine (12%) had no insomnia, 34 (45.3%) had subthreshold insomnia, 22 (29.3%) had moderate insomnia and 10 (13.3%) had severe insomnia. The mean ISI score was 14.95 ± 6.05, with 88% of patients having ISI scores of >7 (95% confidence interval: 0.822–0.965). The frequency of new-onset insomnia was significantly higher among patients who shared a room compared to those in single-bed rooms (95.7% versus 75%; P = 0.011). Other factors were not found to be associated with new-onset insomnia, including the administration of medications known to cause insomnia, in-hospital sedative use, overnight oxygen, cardiac monitoring and self-reported nocturnal toilet use. Overall, insomnia resolution occurred in 78.7% of patients two weeks after discharge.ConclusionThere was a high incidence of acute new-onset insomnia among hospitalised patients at a tertiary centre in Lebanon. Additional research is recommended to further examine inhospital sleep disturbance factors and to seek convenient solutions to limit insomnia.