Anest. intenziv. Med. 2025;36(3):167-174 | DOI: 10.36290/aim.2025.032

The influence of anxiety and environmental factors on sleep quality in patients hospitalized in intensive care unitsOriginal Article

Locihová H.^{1, 2}, Šrámková K.³, Slonková J.^{3, 4}, Zoubková R.^{2, 5}, Maternová K.⁶, Šonka K.⁷, Jarošová D.¹

¹ Ústav ošetřovatelství a porodní asistence, Lékařská fakulta, Ostravská univerzita

² Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta, Ostravská univerzita

³ Neurologická klinika, Fakultní nemocnice Ostrava

⁴ Katedra klinických neurověd, Lékařská fakulta, Ostravská univerzita

⁵ Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Ostrava

⁶ II. chirurgická klinika - kardiovaskulární chirurgie, Všeobecná fakultní nemocnice v Praze

⁷ Neurologická klinika a centrum klinických neurověd, 1. lékařská fakulta Univerzity Karlovy, Všeobecná fakultní nemocnice v Praze

Introduction: Sleep is a fundamental component of human health, and its quality can be affected by various psychological and environmental factors.

Objective: This study aimed to determine the level of anxiety in patients hospitalized in the intensive care unit (ICU), analyze its relationship with sleep quality, and identify environmental factors that disrupt this quality.

Methods: A multicenter cross-sectional study was conducted in ICUs of six selected hospitals in the Czech Republic. The ICU Sleep Questionnaire (SICQ) and the Beck Anxiety Inventory assessed subjective sleep quality and anxiety levels.

Results: A total of 267 ICU patients were included. Higher levels of anxiety were significantly associated with poorer sleep quality (R = -0.41; p < 0.001), with anxiety accounting for 19.6% of the variance in sleep quality. Subjective sleep quality (on a 0-10 scale) was lowest after the first night (4.5 ± 2.5), improved mid-stay (5.3 ± 2.1), and further enhanced by the end of the ICU stay (5.8 ± 2.2); however, it remained lower than at home (7.0 ± 2.3). A positive correlation was observed between sleep quality at home and in the ICU (r = 0.342; p < 0.001). Daytime sleepiness correlated with poor sleep (r = 0.206; p < 0.001). ICU environmental factors negatively affected sleep quality (Ra = -0.804 to -0.114), accounting for 13.7% of the variance in sleep quality.

Conclusion: Elevated anxiety levels, pre-hospitalization sleep problems, increased daytime sleepiness, and unfavorable ICU environmental conditions negatively influence patients' subjective sleep quality during ICU hospitalization.

Keywords: sleep, intensive care unit, environmental factors, anxiety, daytime sleepiness.

Received: April 12, 2025; Revised: June 16, 2025; Accepted: July 21, 2025; Prepublished online: July 31, 2025; Published: September 30, 2025  Show citation