Environmental Factors Affecting Sleep Quality in Intensive Care Unit Patients in Southern Morocco: An Assessment Study

Introduction: Sleep disturbances are a commonly underestimated complication of intensive care unit (ICU) stays. This study aimed to assess sleep quality among ICU patients and to analyze the environmental and clinical factors influencing sleep quality during their stay in the ICU. Methods: We conducted a six-month cross-sectional study involving patients who stayed in the ICU for ≥ 3 nights and were oriented to time and place upon discharge. Sleep quality was assessed using the Arabic version of the Freedman sleep questionnaire, examining both environmental and non-environmental factors, such as illness severity and pain. Differences across three periods were analyzed using the Wilcoxon test and Spearman correlation, while multiple regression analyses identified factors influencing sleep quality. Statistical analyses were performed using JAMOVI software (version 2.3.28). Results: 328 patients were recruited. The average age was 49.74 ± 17.89 years. 75.3% of the participants were adults. The primary admission reasons were circulatory distress 45.73%, followed by metabolic disorders 24.09%. Self-reported sleep quality score at home and the ICU strongly indicated a difference in sleep quality between the two environments (Z = -14.870, p < 0.001), with significantly lower ranks for sleep quality in the ICU. The EVA and APACHE II scores showed a statistically significant effect on sleep quality (p < 0.001 and p= 0.015), while the Charlson and Quick Sofa scores are not significant (p = 0.128 and p=0.894). Several environmental factors showed a statistically significant impact on sleep quality such noise (p = 0.008), light (p = 0.009), and nursing intervention (p=0.009) significantly influence sleep quality. Conclusion: Patients generally reported a poor perception of nighttime sleep quality. Enhancing the pain management and minimizing both environmental noise and staff-related disturbances could significantly improve their sleep quality.