Predictors of Sleep Quality in Patients Undergoing Open-Heart Surgery

Predictors of Sleep Quality in Patients Undergoing Open-Heart Surgery: A Hierarchical Regression Analysis

Sleep quality is a complex and multidimensional phenomenon shaped by the interaction of patient characteristics, symptom burden, and environmental factors specific to the intensive care unit environment. Despite this multidimensional nature, studies identifying predictors of sleep quality in intensive care units after cardiac surgery are limited.

Study Overview

• Status: Completed
• Conditions: Sleep Quality; Nursing Care; Intensive Care (ICU)

Detailed Description

Sleep is a fundamental biological process necessary for maintaining physiological homeostasis, supporting immune function, and promoting healing. Sleep quality is a multidimensional construct influenced by individual characteristics such as age and body mass index, as well as psychological factors like stress and anxiety, and environmental factors such as noise, light, lack of privacy, and care practices. However, patients in intensive care units often experience poor sleep quality, characterized by reduced sleep duration, fragmented sleep, prolonged sleep latency, and frequent awakenings. Poor sleep quality in intensive care units leads to a higher incidence of delirium and atrial fibrillation complications in patients during the postoperative period, delayed recovery time, negative impact on immune function, and prolonged stay in the intensive care unit. Open heart surgery is a frequently performed operation in ischemic and non-ischemic heart diseases (valve diseases, aortic stenosis, and atrial septal defect, etc.) that requires close monitoring of patients in an intensive care environment after surgery. Following these surgeries, physiological issues such as pain, surgical wound problems, fatigue, dyspnea, and sleep problems commonly experienced by patients in intensive care settings, and psychological issues such as anxiety, stress, fear of death negatively affect sleep quality. In addition, individual characteristics such as age and body mass index (BMI) can also affect sleep quality in this patient population. Poor sleep quality in intensive care units is a commonly reported problem by patients, but due to its multifaceted nature, it is often not effectively managed. Although previous studies have reported the prevalence of sleep disorders in intensive care patients, most studies have failed to adopt a comprehensive and multifactorial approach that examines the variables affecting sleep quality individually. This situation highlights the need for studies using multivariate analytical methods to identify independent predictors of sleep quality. The aim of this study is to examine the predictors of sleep quality in patients undergoing open heart surgery and admitted to the cardiovascular surgery intensive care unit, using a multivariate approach.

• Study Type: Observational
• Enrollment (Actual): 157

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Zafer Mahallesi
    • Aydin, Zafer Mahallesi, Turkey (Türkiye), 09010
      • Aydın Adnan Menderes University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients admitted to the cardiovascular intensive care unit after open heart surgery

Description

Inclusion Criteria:

• ability to understand and speak Turkish,
• willingness to participate in the study,
• having spent at least 24 hours in the intensive care unit, and
• having the cognitive ability to understand and answer questions.

Exclusion Criteria:

• having taken narcotic or sedative drugs within the last 48 hours,
• having a history of chronic diseases that can cause sleep problems such as Chronic Obstructive Pulmonary Disease or sleep apnea,
• having a psychiatric illness diagnosed by a physician,
• having a visual or hearing impairment.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain	Assessed wit Visual Analog Scale. his scale is a unidimensional, self-report instrument measuring 10 cm in length. The lower end corresponds to a score of 0, labeled 'no pain,' while the upper end corresponds to a score of 10, labeled 'unbearable pain.' Higher scores on the scale indicate greater severity of pain as reported by the patient.	At least 24 hours after admission to the intensive care unit
Sleep quality	Assessed with Richard- Campbell Sleep Questionnaire. he scale consists of 6 items assessing sleep quality, nocturnal sleep depth, frequency of awakening, ambient noise level, time spent awake, and sleep onset latency. Each item is rated on a visual analog scale ranging from 0 to 100. The total score obtained from the scale is divided by the number of items to calculate the scale score. A scale score between 0 and 25 is interpreted as very poor sleep, while a score between 76 and 100 is interpreted as very good sleep.	At least 24 hours after admission to the intensive care unit
Fatigue	Assessed wit Visual Analog Scale. his scale is a unidimensional, self-report instrument measuring 10 cm in length. The lower end corresponds to a score of 0, labeled 'no fatigue,' while the upper end corresponds to a score of 10, labeled 'unbearable fatigue.' Higher scores on the scale indicate greater severity of fatigue as reported by the patient.	At least 24 hours after admission to the intensive care unit
Environmental Stressors	Assessed with Intensive Care Unit Environmental Stressors Scale. The scale is of a 4-point Likert type and consists of 42 items. The minimum possible score is 42 and the maximum is 168. Higher scores are interpreted as indicating a greater degree of being affected by environmental stressors.	At least 24 hours after admission to the intensive care unit

Collaborators and Investigators

• Sponsor: Aydin Adnan Menderes University

Study record dates

Study Major Dates

• Study Start (Actual): September 15, 2025
• Primary Completion (Actual): March 15, 2026
• Study Completion (Actual): May 15, 2026

Study Registration Dates

• First Submitted: August 5, 2026
• First Submitted That Met QC Criteria: August 5, 2026
• First Posted (Actual): August 10, 2026

Study Record Updates

• Last Update Posted (Actual): August 10, 2026
• Last Update Submitted That Met QC Criteria: August 5, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Mental Disorders; Sleep Wake Disorders; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Initiation and Maintenance Disorders
• Other Study ID Numbers: Predictors of Sleep Quality

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
• IPD Sharing Time Frame: 12 months after publication
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No