Determinants of Sleep Quality in Moroccan Intensive Care Units: A Cross-sectional Study

Abstract

Background: Sleep disruption in intensive care units (ICUs) is a frequent and multifactorial issue with significant implications for patient recovery. Objectives: This study aimed to assess sleep quality in ICU patients and to identify sociodemographic, clinical, and pathological factors associated with impaired sleep. Methods: A cross-sectional observational study was conducted in three ICUs in the Souss-Massa region (Southern Morocco) between February 2023 and March 2025. A sample of 245 conscious adult patients was included in the study. Sleep quality was assessed using the validated Moroccan version of the Richards-Campbell Sleep Questionnaire (RCSQ). Statistical analysis included the chi-square test, Fisher's exact test, and multiple linear regression. Results: Of the 245 patients, 74.7% reported poor sleep quality. Elderly females and patients with a sedentary lifestyle were significantly associated with poorer sleep quality (P < 0.05). Clinically, respiratory and heart diseases, diabetes, and the use of invasive devices were more common in patients with impaired sleep. The Visual Analogue Scale (VAS) pain, Charlson, SOFA, and APACHE II scores were significantly higher in this group (P < 0.001), indicating the negative impact of pain, comorbidities, and disease severity on patients' sleep quality. Conclusions: This study highlights that multiple factors, including age, gender, underlying conditions, medical treatments, and environmental disturbances, influence sleep quality in the ICU. Tailored interventions addressing modifiable risks, such as reducing noise, optimizing treatments, and adapting care, may improve sleep and recovery outcomes in the ICU. These findings have practical implications for ICU professionals and healthcare policymakers aiming to improve care standards in critical care settings.