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

Yue JinShuya Wang^*

• Department of Trauma Center, The Second People's Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou, China

Aim: Sleep disorders are very common and serious in trauma patients, especially in severe patients, and have a negative impact on physical functions of patients. This study was to explore the status and influencing factors of sleep quality in severe trauma patients with non-continuous sedation. Methods: This was a prospective observational study performed in our hospital. A total of 139 patients with non-continuous sedation of severe trauma were selected as the research objectives. Objective sleep quality was continuously monitored for seven consecutive nights using the Fitbit Charge 2 to obtain total sleep time (TST), while subjective sleep quality was assessed each morning using the Richards–Campbell Sleep Questionnaire (RCSQ). Demographic, clinical, environmental, and psychosocial variables were collected concurrently. Univariate and multiple linear regression analyses were conducted to examine the predictors of sleep quality at different time points Results: The average nighttime TST of the participants was 299.76 ± 85.22 minutes, and the mean RCSQ score was 51.38 ± 13.67, indicating generally poor sleep quality. Both objective and subjective sleep measures showed the poorest values on day 1, followed by gradual improvement through day 7. Multivariate regression analyses revealed that the major predictors of reduced sleep included 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 nighttime non-invasive procedures. Conclusion: Severe trauma patients without continuous sedation experience markedly impaired sleep during the early post-injury period, with gradual improvement over time but persistent influence from multiple clinical, environmental, and psychological factors. The study highlights modifiable determinants-such as pain control, environmental management, and reduced nighttime procedures-that may serve as important targets for clinical sleep-promoting interventions in trauma care.