Cent Eur J Nurs Midw 2025, 16(1):2119-2126 | DOI: 10.15452/cejnm.2025.16.0008

Factors influencing sleep disturbances in patients staying in general departments

Hana Locihová1,2, Sabina Psennerová2, Karel Axmann3,4
1 Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Faculty of Medicine, University of Ostrava
2 Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava
3 Department of Anaesthesiology and Intensive Care Medicine, University Hospital Olomouc
4 Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic

Aim: The main objective was to determine how hospitalized patients subjectively perceive sleep disturbances. The study also assessed the influence of selected factors (physiological, physical, environmental, and psychological) and clinical and demographic variables on sleep disruption.

Design:  A multicenter descriptive study.

Methods: Conducted in seven Czech hospitals from February to May 2023, the study included 397 patients in general wards. Data were collected using a modified questionnaire on sleep disturbances, and the results were analyzed using non-parametric statistical tests.

Results: The sample comprised 193 males (48.6 %) and 204 females (51.4%). Females reported more sleep disturbances than males (p = 0.023). Psychological and physical factors had a greater impact on females. Younger patients reported poorer sleep quality (p = 0.015). Pain was the strongest clinical factor that negatively affected sleep (Ra = 0.730). Environmental factors were the leading cause of sleep disturbance in patients (Ra = 0.836). The variability associated with all the factors studied (environmental, psychological, physiological, and physical) accounted for 97.6% of the total variability in sleep disturbance.

Conclusion:  Females and younger patients experienced more sleep disturbance. Pain and environmental factors were the primary causes of disrupted sleep. Differences were noted in the factors affecting sleep between genders.

Keywords: factors, general department, patients, sleep disturbance

Received: October 18, 2024; Revised: February 12, 2025; Accepted: February 25, 2025; Published: March 6, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Locihová H, Psennerová S, Axmann K. Factors influencing sleep disturbances in patients staying in general departments. Central European Journal of Nursing and Midwifery. 2025;16(1):2119-2126. doi: 10.15452/cejnm.2025.16.0008.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Adams, C., Harrison, R., Schembri, A., Junge, M., & Walpola, R. (2024). The silent threat: Investigating sleep disturbances in hospitalized patients. International Journal for Quality in Health Care, 36(2), mzae042. https://doi.org/10.1093/intqhc/mzae042 Go to original source... Go to PubMed...
    2. Affini, M. I., Arora, V. M., Gulati, J., Mason, N., Klein, A., Cho, H. J., Clarke, K., Lee, V., McDaniel, L. M., & Orlov, N. M. (2022). Defining existing practices to support the sleep of hospitalized patients: a mixed-methods study of top-ranked hospitals. Journal of Hospital Medicine, 17(8), 633-638. https://doi.org/10.1002/jhm.12917 Go to original source... Go to PubMed...
    3. Acharya, R., Blackwell, S., Simoes, J., Harris, B., Booth, L., Bhangu, A., & Glasbey, J. (2024). Non-pharmacological interventions to improve sleep quality and quantity for hospitalized adult patients-co-produced study with surgical patient partners: systematic review. BJS Open, 8(2), zrae018. https://doi.org/10.1093/bjsopen/zrae018 Go to original source... Go to PubMed...
    4. Alessandrini, V., Rose, M., Gibby, A., & Polychronakis, T. (2023). P19 Evaluation of sleep quality via actigraphy monitoring in paediatric patients attending for hospital sleep study compared to sleep at home. BMJ Open Respiratory Research, 10(Suppl 1), A1-A44. https://doi.org/10.1136/bmjresp-2023-BSSconf.30 Go to original source...
    5. Alvaro, P. K., Roberts, R. M., & Harris, J. K. (2013). A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep, 36(7), 1059-1068. https://doi.org/10.5665/sleep.2810 Go to original source... Go to PubMed...
    6. Antza, C., Kostopoulos, G., Mostafa, S., Nirantharakumar, K., & Tahrani, A. (2021). The links between sleep duration, obesity and type 2 diabetes mellitus. The Journal of Endocrinology, 252(2), 125-141. https://doi.org/10.1530/JOE-21-0155 Go to original source... Go to PubMed...
    7. Binte Arman, S. N., Lee, Y. H., Lopez, V., & Lim, S. H. (2022). Subjective sleep quality among hospitalised adult patients: an observational, cross-sectional study. Proceedings of Singapore Healthcare, 31. https://doi.org/10.1177/20101058221111664 Go to original source...
    8. Boivin, D. B., Shechter, A., Boudreau, P., Begum, E. A., & Ng Ying-Kin, N. M. K. (2016). Diurnal and circadian variation of sleep and alertness in men vs. naturally cycling women. Proceedings of the National Academy of Sciences of the United States of America, 113(39), 10980-10985. https://doi.org/10.1073/pnas.1524484113 Go to original source... Go to PubMed...
    9. Burger, P., Van den Ende, E. S., Lukman, W., Burchell, G. L., Steur, L. M. H., Merten, H., Nanayakkara, P. W. B., & Gemke, R. J. B. J. (2022). Sleep in hospitalized pediatric and adult patients - a systematic review and meta-analysis. Sleep Medicine: X, 4, 100059. https://doi.org/10.1016/j.sleepx.2022.100059 Go to original source... Go to PubMed...
    10. Cascais, A. F., & Cunha, M. (2024). Clinical, psychological and environmental factors that affect sleep quality of in surgical patients. Health Science Journal, 14, e1494-e1494. https://doi.org/10.21876/hsjhci.v14.2024.e1494 Go to original source...
    11. Chaput, J.-P., McHill, A. W., Cox, R. C., Broussard, J. L., Dutil, C., da Costa, B. G. G., Sampasa-Kanyinga, H., & Wright, K. P. (2023). The role of insufficient sleep and circadian misalignment in obesity. Nature Reviews. Endocrinology, 19(2), 82-97. https://doi.org/10.1038/s41574-022-00747-7 Go to original source... Go to PubMed...
    12. D'souza, O. L., Alvares, I. T. R., & Baliga, M. S. (2019). Factors affecting quality of sleep in hospitalized patients: a cross-sectional survey in a tertiary care hospital. Indian Journal of Medical Specialities, 10(4), 201. https://doi.org/10.4103/INJMS.INJMS_17_19 Go to original source...
    13. Elías, M. N. (2021). Assessment and monitoring of sleep in the intensive care unit. Critical Care Nursing Clinics of North America, 33(2), 109-119. https://doi.org/10.1016/j.cnc.2021.01.008 Go to original source... Go to PubMed...
    14. Fatima, Y., Doi, S. A. R., Najman, J. M., & Mamun, A. A. (2016). Exploring gender difference in sleep quality of young adults: findings from a large population study. Clinical Medicine & Research, 14(3-4), 138-144. https://doi.org/10.3121/cmr.2016.1338 Go to original source... Go to PubMed...
    15. Goldstein, A. N., & Walker, M. P. (2014). The role of sleep in emotional brain function. Annual Review of Clinical Psychology, 10, 679-708. https://doi.org/10.1146/annurev-clinpsy-032813-153716 Go to original source... Go to PubMed...
    16. Adams, C., Harrison, R., Schembri, A., Junge, M., & Walpola, R. (2024). The silent threat: Investigating sleep disturbances in hospitalized patients. International Journal for Quality in Health Care, 36(2), mzae042. https://doi.org/10.1093/intqhc/mzae042 Go to original source... Go to PubMed...
    17. Affini, M. I., Arora, V. M., Gulati, J., Mason, N., Klein, A., Cho, H. J., Clarke, K., Lee, V., McDaniel, L. M., & Orlov, N. M. (2022). Defining existing practices to support the sleep of hospitalized patients: a mixed-methods study of top-ranked hospitals. Journal of Hospital Medicine, 17(8), 633-638. https://doi.org/10.1002/jhm.12917 Go to original source... Go to PubMed...
    18. Acharya, R., Blackwell, S., Simoes, J., Harris, B., Booth, L., Bhangu, A., & Glasbey, J. (2024). Non-pharmacological interventions to improve sleep quality and quantity for hospitalized adult patients-co-produced study with surgical patient partners: systematic review. BJS Open, 8(2), zrae018. https://doi.org/10.1093/bjsopen/zrae018 Go to original source... Go to PubMed...
    19. Alessandrini, V., Rose, M., Gibby, A., & Polychronakis, T. (2023). P19 Evaluation of sleep quality via actigraphy monitoring in paediatric patients attending for hospital sleep study compared to sleep at home. BMJ Open Respiratory Research, 10(Suppl 1), A1-A44. https://doi.org/10.1136/bmjresp-2023-BSSconf.30 Go to original source...
    20. Alvaro, P. K., Roberts, R. M., & Harris, J. K. (2013). A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep, 36(7), 1059-1068. https://doi.org/10.5665/sleep.2810 Go to original source... Go to PubMed...
    21. Antza, C., Kostopoulos, G., Mostafa, S., Nirantharakumar, K., & Tahrani, A. (2021). The links between sleep duration, obesity and type 2 diabetes mellitus. The Journal of Endocrinology, 252(2), 125-141. https://doi.org/10.1530/JOE-21-0155 Go to original source... Go to PubMed...
    22. Binte Arman, S. N., Lee, Y. H., Lopez, V., & Lim, S. H. (2022). Subjective sleep quality among hospitalised adult patients: an observational, cross-sectional study. Proceedings of Singapore Healthcare, 31. https://doi.org/10.1177/20101058221111664 Go to original source...
    23. Boivin, D. B., Shechter, A., Boudreau, P., Begum, E. A., & Ng Ying-Kin, N. M. K. (2016). Diurnal and circadian variation of sleep and alertness in men vs. naturally cycling women. Proceedings of the National Academy of Sciences of the United States of America, 113(39), 10980-10985. https://doi.org/10.1073/pnas.1524484113 Go to original source... Go to PubMed...
    24. Burger, P., Van den Ende, E. S., Lukman, W., Burchell, G. L., Steur, L. M. H., Merten, H., Nanayakkara, P. W. B., & Gemke, R. J. B. J. (2022). Sleep in hospitalized pediatric and adult patients - a systematic review and meta-analysis. Sleep Medicine: X, 4, 100059. https://doi.org/10.1016/j.sleepx.2022.100059 Go to original source... Go to PubMed...
    25. Cascais, A. F., & Cunha, M. (2024). Clinical, psychological and environmental factors that affect sleep quality of in surgical patients. Health Science Journal, 14, e1494-e1494. https://doi.org/10.21876/hsjhci.v14.2024.e1494 Go to original source...
    26. Chaput, J.-P., McHill, A. W., Cox, R. C., Broussard, J. L., Dutil, C., da Costa, B. G. G., Sampasa-Kanyinga, H., & Wright, K. P. (2023). The role of insufficient sleep and circadian misalignment in obesity. Nature Reviews. Endocrinology, 19(2), 82-97. https://doi.org/10.1038/s41574-022-00747-7 Go to original source... Go to PubMed...
    27. D'souza, O. L., Alvares, I. T. R., & Baliga, M. S. (2019). Factors affecting quality of sleep in hospitalized patients: a cross-sectional survey in a tertiary care hospital. Indian Journal of Medical Specialities, 10(4), 201. https://doi.org/10.4103/INJMS.INJMS_17_19 Go to original source...
    28. Elías, M. N. (2021). Assessment and monitoring of sleep in the intensive care unit. Critical Care Nursing Clinics of North America, 33(2), 109-119. https://doi.org/10.1016/j.cnc.2021.01.008 Go to original source... Go to PubMed...
    29. Fatima, Y., Doi, S. A. R., Najman, J. M., & Mamun, A. A. (2016). Exploring gender difference in sleep quality of young adults: findings from a large population study. Clinical Medicine & Research, 14(3-4), 138-144. https://doi.org/10.3121/cmr.2016.1338 Go to original source... Go to PubMed...
    30. Goldstein, A. N., & Walker, M. P. (2014). The role of sleep in emotional brain function. Annual Review of Clinical Psychology, 10, 679-708. https://doi.org/10.1146/annurev-clinpsy-032813-153716 Go to original source... Go to PubMed...
    31. Grandner, M., Mullington, J. M., Hashmi, S. D., Redeker, N. S., Watson, N. F., & Morgenthaler, T. I. (2018). Sleep Duration and hypertension: analysis of > 700,000 adults by age and sex. Journal of Clinical Sleep Medicine, 14(6), 1031-1039. https://doi.org/10.5664/jcsm.7176 Go to original source... Go to PubMed...
    32. Hillman, D. R., Carlucci, M., Charchaflieh, J. G., Cloward, T. V., Gali, B., Gay, P. C., Lyons, M. M., McNeill, M. M., Singh, M., Yilmaz, M., & Auckley, D. H. (2023). Society of anesthesia and sleep medicine position paper on patient sleep during hospitalization. Anesthesia and Analgesia, 136(4), 814-824. https://doi.org/10.1213/ANE.0000000000006395 Go to original source... Go to PubMed...
    33. Jeffs, E. L., & Darbyshire, J. L. (2019). Measuring sleep in the intensive care unit: a critical appraisal of the use of subjective methods. Journal of Intensive Care Medicine, 34(9), 751-760. https://doi.org/10.1177/0885066617712197 Go to original source... Go to PubMed...
    34. Knauert, M. P., Ayas, N. T., Bosma, K. J., Drouot, X., Heavner, M. S., Owens, R. L., Watson, P. L., Wilcox, M. E., Anderson, B. J., Cordoza, M. L., Devlin, J. W., Elliott, R., Gehlbach, B. K., Girard, T. D., Kamdar, B. B., Korwin, A. S., Lusczek, E. R., Parthasarathy, S., Spies, C., … 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. https://doi.org/10.1164/rccm.202301-0184ST Go to original source... Go to PubMed...
    35. Knechel, N. A., & Chang, P.-S. (2022). The relationships between sleep disturbance and falls: a systematic review. Journal of Sleep Research, 31(5), e13580. https://doi.org/10.1111/jsr.13580 Go to original source... Go to PubMed...
    36. Kuhlmann, J., Alhammadi, E., Mevissen, A., & Möllmann, H. (2023). Delirium and sleep disturbances - a narrative review. Zeitschrift Fur Gerontologie Und Geriatrie, 56(7), 539-544. https://doi.org/10.1007/s00391-023-02228-6 Go to original source... Go to PubMed...
    37. Kulpatcharapong, S., Chewcharat, P., Ruxrungtham, K., Gonlachanvit, S., Patcharatrakul, T., Chaitusaney, B., Muntham, D., Reutrakul, S., & Chirakalwasan, N. (2020). Sleep quality of hospitalized patients, contributing factors, and prevalence of associated disorders. Sleep Disorders, 2020, 8518396. https://doi.org/10.1155/2020/8518396 Go to original source... Go to PubMed...
    38. Locihová, H., Axmann, K., & ®iaková, K. (2021). Sleep-disrupting effects of nocturnal nursing interventions in intensive care unit patients: a systematic review. Journal of Sleep Research, 30(4), e13223. https://doi.org/10.1111/jsr.13223 Go to original source... Go to PubMed...
    39. Lok, R., Qian, J., & Chellappa, S. L. (2024). Sex differences in sleep, circadian rhythms, and metabolism: implications for precision medicine. Sleep Medicine Reviews, 75, 101926. https://doi.org/10.1016/j.smrv.2024.101926 Go to original source... Go to PubMed...
    40. Miller, M. A., & Howarth, N. E. (2023). Sleep and cardiovascular disease. Emerging Topics in Life Sciences, 7(5), 457-466. https://doi.org/10.1042/ETLS20230111 Go to original source... Go to PubMed...
    41. Palagini, L., Zerbinati, L., Balestrieri, M., Belvederi Murri, M., Caruso, R., D'Agostino, A., Ferrara, M., Ferrari, S., Minervino, A., Massa, L., Milia, P., Miniati, M., Maria Giulia, N., Petrucci, A., Pini, S., Politi, P., Porcellana, M., Rocchetti, M., Taddei, I., … Grassi, L. (2023). Poor sleep quality may contribute to dysfunctional illness perception, physical and emotional distress in hospitalised patients: results of a national survey of the Italian Society of Consultation-Liaison Psychiatry. Journal of Sleep Research, 32(1), e13617. https://doi.org/10.1111/jsr.13617 Go to original source... Go to PubMed...
    42. Pamuk, K., & Turan, N. (2022). The effect of light on sleep quality and physiological parameters in patients in the intensive care unit. Applied Nursing Research, 66, 151607. https://doi.org/10.1016/j.apnr.2022.151607 Go to original source... Go to PubMed...
    43. Rasch, B., & Born, J. (2013). About sleep's role in memory. Physiological Reviews, 93(2), 681-766. https://doi.org/10.1152/physrev.00032.2012 Go to original source... Go to PubMed...
    44. Raymond, I., Nielsen, T. A., Lavigne, G., Manzini, C., & Choinière, M. (2001). Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patients. Pain, 92(3), 381-388. https://doi.org/10.1016/S0304-3959(01)00282-2 Go to original source... Go to PubMed...
    45. Rinehart, M. C., Ghorashi, S., Heavner, M. S., Tata, A., Bathula, M., Kelly, S., Yeung, S. Y. A., Landolf, K., So, J. Y., Goel, N., & Grover, B. E. (2024). Reprint of: An assessment of a sleep aid and sleep promotion practices in hospitalized medical patients. Journal of the American Pharmacists Association, 64(4), 102182. https://doi.org/10.1016/j.japh.2024.102182 Go to original source... Go to PubMed...
    46. Rundo, J. V., & Downey, R. (2019). Polysomnography. Handbook of clinical neurology, 160, 381-392. https://doi.org/10.1016/B978-0-444-64032-1.00025-4 Go to original source... Go to PubMed...
    47. Saleem, M., Shabir, H., Haris, M., Naqvi, S. A., Ain, Q. U., Azfar, H., & Hashim, A. (2024). Association between sleep quality and musculoskeletal pain in patients with osteoarthritis. Journal of Health and Rehabilitation Research, 4(2), 90-93. https://doi.org/10.61919/jhrr.v4i2.783 Go to original source...
    48. Schwab, K. E., Ronish, B., Needham, D. M., To, A. Q., Martin, J. L., & Kamdar, B. B. (2018). Actigraphy to evaluate sleep in the intensive care unit. A systematic review. Annals of the American Thoracic Society, 15(9), 1075-1082. https://doi.org/10.1513/AnnalsATS.201801-004OC Go to original source... Go to PubMed...
    49. Weller, J., Ceschi, A., Hirsch, L., Sartori, R., & Costantini, A. (2018). Accounting for individual differences in decision-making competence: personality and gender differences. Frontiers in Psychology, 9, 2258. https://doi.org/10.3389/fpsyg.2018.02258 Go to original source... Go to PubMed...
    50. Wesselius, H. M., van den Ende, E. S., Alsma, J., Ter Maaten, J. C., Schuit, S. C. E., Stassen, P. M., de Vries, O. J., Kaasjager, K. H. A. H., Haak, H. R., van Doormaal, F. F., Hoogerwerf, J. J., Terwee, C. B., van de Ven, P. M., Bosch, F. H., van Someren, E. J. W., & Nanayakkara, P. W. B. (2018). Quality and quantity of sleep and factors associated with sleep disturbance in hospitalized patients. JAMA Internal Medicine, 178(9), 1201-1208. https://doi.org/10.1001/jamainternmed.2018.2669 Go to original source... Go to PubMed...
    51. Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of good practice for the translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. Value in Health, 8(2), 94-104. https://doi.org/10.1111/j.1524-4733.2005.04054.x Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content