# Analysis of influencing factors of sleep quality in severe trauma patients without continuous sedation

## TL;DR

This study examines sleep quality in severely injured patients not receiving continuous sedation, identifying factors like pain and environment that affect their sleep.

## Contribution

The study identifies specific modifiable factors affecting sleep quality in non-sedated severe trauma patients.

## Key findings

- Sleep quality in severe trauma patients is poor initially but improves over time.
- Pain intensity, environmental noise, and nighttime procedures are significant predictors of poor sleep quality.

## Abstract

Sleep disorders are very common and serious among trauma patients, particularly in those with severe trauma, and have a negative impact on patients’ physiological functioning. This study aimed to explore the status and influencing factors of sleep quality in severe trauma patients receiving non-continuous sedation.

The prospective observational study was conducted in our hospital. A total of 139 patients receiving non-continuous sedation for severe trauma were selected as the research objectives. Objective: Sleep quality was continuously monitored for seven consecutive nights using the Fitbit Charge 2 to measure total sleep time (TST), while subjective sleep quality was assessed each morning using the Richards–Campbell Sleep Questionnaire (RCSQ). Demographical, clinical, environmental, and psychosocial variables were collected concurrently. Univariate and multiple linear regression analyses were performed to identify the predictors of sleep quality at different time points.

The average nighttime TST among the participants was 299.76 ± 85.22 min, and the mean RCSQ score was 51.38 ± 13.67, indicating generally poor sleep quality. Both objective and subjective sleep measures were poorest on day 1 and showed gradual improvement through day 7. Multivariate regression analyses identified several major predictors of reduced sleep quality, including pain intensity, thirst severity, environmental noise and light levels, ward temperature, pre-admission sleep status, trauma site (limbs), anxiety level, duration of visits, use of sleep aids, and the frequency of night-time non-invasive procedures.

Severe trauma patients without continuous sedation experience markedly impaired sleep during the early post-injury period, with gradual improvement over time but persistent effects from multiple clinical, environmental, and psychological factors. The findings highlight several modifiable determinants—such as pain control, environmental management, and reduced nighttime procedures—that may serve as key targets for clinical sleep-promoting interventions in trauma care.