Other Titles

Anxiety and Sleep Disruption among Intensive Care Unit Patients: A Scoping Review [Poster Title]

Abstract

Background: Anxiety and sleep disruption are common, interrelated symptoms among intensive care unit (ICU) patients.1,2 These symptoms contribute to psychological distress, which can persist for months and impact the patients' recovery.3 Recent clinical guidelines from the Society of Critical Care Medicine highlighted anxiety as a key risk factor for sleep disruption.4 Thus, understanding the interplay of anxiety and sleep disruption and developing effective interventions to mitigate both are essential.

Purpose: This scoping review aimed to identify existing literature that quantitatively examined anxiety and sleep disruption among adult ICU patients.

Methods: Following the scoping review guidelines from the Joanna Briggs Institute,5 a systematic search was conducted across five databases: Ovid Medline, Ovid Embase, CINAHL, Cochrane Library, and Scopus.

Results Of the 2,351 studies identified, 14 met the inclusion criteria. Over half of the studies (64.3%) were published since 2014, indicating recent interest. Most studies were conducted in the ICUs, but three studies (21.4%) also recruited patients outside of the ICU to capture recalled ICU memories. In six studies (42.8%), anxiety and sleep were both measured as outcomes of interventions, which were mostly non-pharmaceutical and were generally effective in lowering anxiety levels and improving sleep quality. Only one study (7.2%) examined sleep disruption as a risk factor for anxiety. Others were observational studies that explored anxiety as a predictor of sleep disruption (14.3%), or which simply described two symptoms (35.7%). Anxiety and sleep disruption were measured using various tools, with the Richard-Campbell Sleep Questionnaire (28.6%) and Hospital Anxiety and Depression Scale (21.4%) being the most frequently used. Commonly reported risk factors for both symptoms were pain, noise, light, analgesics, sedatives, and mechanical ventilation. Also, anxiety and sleep disruption were identified as common risk factors for each other.

Conclusion: In this review, we found that anxiety and sleep disruption are prevalent and interrelated symptoms in ICU patients. Studies tended to mainly describe them as distressing symptoms or intervention outcomes. Future studies should provide deeper insights into their interrelatedness and impact on the recovery of ICU patients. Also, interventions targeting both symptoms should be developed to mitigate stressful memories and psychological trauma from ICU experiences.

Notes

References:

1. Knauert, M. P., Ayas, N. T., Bosma, K. J., Drouot, X., Heavner, M. S., Owens, R. L., ... & Zee, P. C. (2023). Causes, consequences, and treatments of sleep and circadian disruption in the ICU: an official American Thoracic Society Research Statement. American journal of respiratory and critical care medicine, 207(7), e49-e68.

2. Silva, R. D., Teixeira, A. C., Pinho, J. A., Marcos, P., & Santos, J. C. (2024). Sleep, anxiety, depression, and stress in critically ill patients: a descriptive study in a Portuguese intensive care unit. Acute and Critical Care, 39(2), 312.

3.Schwitzer, E., Jensen, K. S., Brinkman, L., DeFrancia, L., VanVleet, J., Baqi, E., ... & Qadir, N. (2023). Survival≠ recovery: a narrative review of post-intensive care syndrome. CHEST Critical Care, 1(1), 100003.

4. Devlin, J. W., Skrobik, Y., Rochwerg, B., Nunnally, M. E., Needham, D. M., Gelinas, C., ... & Alhazzani, W. (2018). Methodologic innovation in creating clinical practice guidelines: insights from the 2018 society of critical care medicine pain, agitation/sedation, delirium, immobility, and sleep disruption guideline effort. Critical care medicine, 46(9), 1457-1463.

5. Peters, M. D., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., ... & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI evidence synthesis, 18(10), 2119-2126.

Description

We conducted a scoping review of existing literature describing anxiety and sleep disruption in ICU patients. A total of 14 studies were included in the analysis, with anxiety and sleep commonly reported as distressing symptoms during ICU stays. Future studies need to investigate the mechanisms linking these two symptoms and develop effective interventions to enhance patient outcomes.

Author Details

Hyunji Kim, PhD, MSN, RN; David Ryamukuru, BSN, RN; Talia Brown, MSN, AGACNP-BC; Deena Costa, PhD, RN, FAAN

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Acute Care, Stress and Coping, Sub-acute Care, Intensive Care Unit, ICU, Anxiety, Sleep Disruption

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

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Anxiety and Sleep Disruption Among ICU Patients: A Scoping Review

Seattle, Washington, USA

Background: Anxiety and sleep disruption are common, interrelated symptoms among intensive care unit (ICU) patients.1,2 These symptoms contribute to psychological distress, which can persist for months and impact the patients' recovery.3 Recent clinical guidelines from the Society of Critical Care Medicine highlighted anxiety as a key risk factor for sleep disruption.4 Thus, understanding the interplay of anxiety and sleep disruption and developing effective interventions to mitigate both are essential.

Purpose: This scoping review aimed to identify existing literature that quantitatively examined anxiety and sleep disruption among adult ICU patients.

Methods: Following the scoping review guidelines from the Joanna Briggs Institute,5 a systematic search was conducted across five databases: Ovid Medline, Ovid Embase, CINAHL, Cochrane Library, and Scopus.

Results Of the 2,351 studies identified, 14 met the inclusion criteria. Over half of the studies (64.3%) were published since 2014, indicating recent interest. Most studies were conducted in the ICUs, but three studies (21.4%) also recruited patients outside of the ICU to capture recalled ICU memories. In six studies (42.8%), anxiety and sleep were both measured as outcomes of interventions, which were mostly non-pharmaceutical and were generally effective in lowering anxiety levels and improving sleep quality. Only one study (7.2%) examined sleep disruption as a risk factor for anxiety. Others were observational studies that explored anxiety as a predictor of sleep disruption (14.3%), or which simply described two symptoms (35.7%). Anxiety and sleep disruption were measured using various tools, with the Richard-Campbell Sleep Questionnaire (28.6%) and Hospital Anxiety and Depression Scale (21.4%) being the most frequently used. Commonly reported risk factors for both symptoms were pain, noise, light, analgesics, sedatives, and mechanical ventilation. Also, anxiety and sleep disruption were identified as common risk factors for each other.

Conclusion: In this review, we found that anxiety and sleep disruption are prevalent and interrelated symptoms in ICU patients. Studies tended to mainly describe them as distressing symptoms or intervention outcomes. Future studies should provide deeper insights into their interrelatedness and impact on the recovery of ICU patients. Also, interventions targeting both symptoms should be developed to mitigate stressful memories and psychological trauma from ICU experiences.