Understanding Nurses’ Practices in Assessing Sleep Disturbances among Critically Ill Patients in Intensive Care Units

Abstract

Background: Sleep disturbances are highly prevalent among critically ill patients in intensive care units (ICUs) and are associated with impaired recovery, reduced physical functioning, and adverse psychological outcomes. Although sleep is increasingly recognized as a critical component of patient recovery, sleep assessment remains inconsistently integrated into routine nursing care. Limited evidence exists regarding how nurses assess sleep disturbances in critically ill patients and the challenges they encounter in clinical practice.

Objective: To explore nurses’ practices and experiences in assessing sleep disturbances among critically ill patients in ICU settings.

Methods: A qualitative descriptive study was conducted among ICU nurses with more than two years of critical care experience and a minimum educational qualification of a Bachelor of Nursing (Ners). Participants were recruited using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis.

Results: Three themes emerged from the analysis. First, nurses recognized sleep disturbances as a common and clinically significant problem among critically ill patients. Second, sleep assessment was primarily based on clinical observations and patient conditions rather than standardized assessment methods. Third, participants identified several barriers to effective assessment, including the absence of standard operating procedures, limited knowledge regarding sleep assessment, and a lack of validated instruments specifically designed for critically ill patients.

Conclusion: Sleep assessment in ICU settings remains largely dependent on nurses’ clinical judgment and lacks standardized approaches. The development and implementation of evidence-based sleep assessment protocols and validated instruments may enhance the early identification of sleep disturbances and strengthen patient-centered critical care nursing practice.