¹ University Hospital Centre Osijek, Josip Huttler Street 4, Osijek, 31000, Osijek-Baranja County, Croatia, kristina.pauzer@kbco.hr; ivana.mitrovic@kbco.hr; nfarcic@fdmz.hr

² Department of Nursing and Palliative Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena Street 21, Osijek, 31000, Osijek-Baranja County, Croatia, mcebohin@fdmz.hr; zgvozdanovic@fdmz; zdujmic@fdmz.hr; majacarevic2009@gmail.com

³ General County Hospital Našice, Bana Jelačić Street 10, Našice, 31500, Osijek-Baranja County, Croatia

⁴ General Hospital “Dr. Josip Benčević” Slavonski Brod, Andrije Štampara Street 42, Slavonski Brod, 35 000, Brod-Posavina County, Croatia

⁵ Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josip Huttler Street 4, Osijek, 31000, Osijek-Baranja County, Croatia

⁶ Department of Nursing, University of Applied Sciences in Bjelovar, Trg Eugena Kvaternika 4, Bjelovar, 43000, Bjelovar-Bilogora County, Croatia, grafaj@vub.hr

⁷ Medical School Osijek, Vukovarska cesta 209, Osijek, 31000, Croatia, majacarevic2009@gmail.com

Abstract

Introduction: Sleep plays a crucial role in the recovery of patients in the intensive care unit (ICU), yet it is frequently disrupted by specific environmental and clinical factors. Sleep quality influences the cognitive, emotional, and physical health of patients and is recognized as an important component of the treatment process. The aim of this study was to examine how hospitalized ICU patients perceive their sleep quality and to identify the main environmental factors that influence it.

Methods: A cross-sectional quantitative study was conducted in the ICU of the Clinical Hospital Center Osijek between February and April 2025. The study included 95 hospitalized patients. Data were collected using a questionnaire developed specifically for this research, based on available literature. Statistical analysis included both descriptive and inferential methods.

Results: The strongest negative associations with sleep quality were observed for the infusion pump alarm sound (ρ = 0.753) and pain (β = 0.274; P=0.003). Diagnostic procedures (β = 0.326; P= 0.002) and blood sampling (β = 0.241; P=0.02) demonstrated weaker but still statistically significant negative associations. No significant differences in sleep quality were observed between sexes (P=0.86), whereas the presence of malignant disease was associated with poorer sleep quality (P=0.04).

Conclusion: Sleep among ICU patients is markedly impaired, particularly due to noise, pain, and frequent nighttime interventions. Additional efforts are needed to optimize the ICU environment, educate healthcare staff, and individualize care to improve sleep quality in intensive care settings.