Insomnia is associated with quality of life impairment in medical-surgical intensive care unit survivors

• Published in: Heart & lung Vol. 44; no. 2; pp. 89 - 94
• Main Authors: Parsons, Elizabeth C., Hough, Catherine L., Vitiello, Michael V., Zatzick, Douglas, Davydow, Dimitry S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2015; Elsevier Science Ltd
• Subjects: Adult; Cardiovascular; Criteria; Critical Care; Cross-Sectional Studies; Depression; Female; Humans; Insomnia; Intensive care; Intensive Care Units; Male; Middle Aged; Outcome assessment; Post-traumatic stress disorder; Prevalence; Psychiatry; Pulmonary/Respiratory; Quality of life; Quality of Life - psychology; Sleep Initiation and Maintenance Disorders - epidemiology; Sleep Initiation and Maintenance Disorders - psychology; Survivor; Survivors - psychology; AUDIT; Intensive care; CAM-ICU; DAST-10; Critical care; Depression; PCL-C; SF-12; PHQ-9; PTSD; MINI; Insomnia; Post-traumatic stress disorder; HRQOL; ICU; Outcome assessment; ISI; HMC; Medical Short Form 12 health-related quality of life questionnaire; Mini International Neuropsychiatric Interview; Patient Health Questionnaire 9-item depression scale; intensive care unit; Alcohol Use Disorders Identification Test; PTSD checklist – civilian version; health-related quality of life; Drug Abuse Screening Test = 10; posttraumatic stress disorder; Harborview Medical Center; Confusion Assessment Method-ICU; insomnia severity index
• ISSN: 0147-9563; 1527-3288; 1527-3288
• DOI: 10.1016/j.hrtlng.2014.11.002

To examine the prevalence of insomnia and its relationship to health-related quality of life (HRQOL) post-intensive care unit (ICU). The burden of post-ICU insomnia is unknown. This cross-sectional study examined data from 120 patients with an ICU stay >24 h. Pre-hospital health was assessed in-hospital. Insomnia, HRQOL and post-ICU psychiatric symptoms were assessed at 12 months post-ICU. Over one-quarter (28%) of subjects met insomnia criteria at 12 months post-ICU. Post-ICU insomnia was independently associated with worse mental HRQOL (P < 0.01), as well as worse scores on the HRQOL sub-domains of bodily pain (P < 0.001), vitality (P < 0.05) and physical function (P < 0.05). However, these associations were no longer significant after adjusting for post-ICU psychiatric symptoms (P = 0.33). Insomnia is common among ICU survivors. Post-ICU insomnia is significantly associated with mental HRQOL and could identify ICU survivors who may benefit from further psychiatric evaluation. •In this medical-surgical cohort, 28% of 1-year survivors endorsed post-ICU insomnia.•Post-ICU insomnia was linked to in-hospital acute stress and opioid exposure.•Post-ICU insomnia was linked to post-hospital depression, PTSD, and pain.•Insomnia may identify ICU survivors who merit evaluation for psychiatric disorders.