Abstract :

Sleep is a vital component of human behavior essential for survival and long-term health. However, hospitalized patients frequently experience poor sleep quality due to environmental and illness-related disruptions, which can hinder recovery. This study aimed to assess sleep quality and identify associated factors among hospitalized patients in a tertiary care setting in the Eastern Region of Saudi Arabia. A descriptive, cross-sectional design was utilized, involving 345 adult participants recruited through convenience sampling. Data were collected using the Richards-Campbell Sleep Questionnaire (RCSQ), assessing five core items: sleep depth, latency, awakenings, return to sleep, and overall quality. Non-parametric tests were employed for data analysis. Patients reported a moderate mean sleep quality score of 3.59/6. Although 69.6% provided a positive overall rating, 63.5% experienced light sleep and 48.4% struggled with sleep latency. Statistical analysis revealed that age and hospital department did not significantly correlate with sleep quality. However, a slight positive correlation was found between longer hospitalization and improved sleep onset, suggesting environmental adaptation. Sleep disturbances are a prevalent, systemic issue in hospital settings, primarily driven by extrinsic environmental factors. Enhancing sleep quality requires institutional interventions, such as implementing protected sleep cycles and reducing nocturnal clinical interruptions.

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Keywords :

Environmental disruptors, Hospitalized patients, Patient-centered care, Richards-Campbell Sleep Questionnaire, Saudi Arabia., sleep quality

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References :

1. Adib-Hajbaghery, M., Izadi-Avanji, F., & Akbari, H. (2012). Quality of sleep and its related risk factors in hospitalized older patients in Kashan’s hospitals, Iran 2009. Iranian Journal of Nursing and Midwifery Research, 17(6), 414–420.
2. 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, Article 100059. https://doi.org/10.1016/j.sleepx.2022.100059
3. Buxton, O. M., Ellenbogen, J. M., Wang, W., Carballeira, A., O’Connor, S., Cooper, D., Gordhandas, A. J., McKinney, S. M., & Solet, J. M. (2012). Sleep disruption due to hospital noises: A prospective evaluation. Annals of Internal Medicine, 157(3), 170–179. https://doi.org/10.7326/0003-4819-157-3-201208070-00472
4. de Gans, C. J., Meewisse, A. J. G., van den Ende, E. S., van Zuylen, M. L., Nanayakkara, P. W. B., Hermanides, J., Stenvers, D. J., Polderman, J. A. W., Janssen, L. M. J., Siegelaar, S. E., van Stijn, M. F. M., Eshuis, W. J., van der Werf, Y. D., Rutters, F., van der Roest-Bor, L., Visser, A., & Smeulers, M. (2025). The effects of sleep improving interventions in medical hospital wards: The WEsleep study A randomized clinical trial. European Journal of Internal Medicine, 139, Article 106308. doi.org
5. El Arab, R. A., Alzghoul, H., Abu-Mahfouz, M. S., Aldarwish, Z., Abbadi, M., Ghashi, E., Alsaffar, G., Alasmkh, W., & Seweid, M. M. (2025). Nurses’ perspectives on the sleep quality of hospitalized patients in Al Ahsa, Saudi Arabia. Nursing Reports, 15(2), 54. https://doi.org/10.3390/nursrep15020054
6. Filip, B., Robyn, S., Esther, R., & Julia, M. (2022). Sleep quality among inpatients of Spanish public hospitals. ResearchGate. researchgate.net
7. Gathecha, E., Rios, R., Buenaver, L. F., Landis, R., Howell, E., & Wright, S. (2016). Pilot study aiming to support sleep quality and duration during hospitalizations. Journal of Hospital Medicine, 11(7), 467–472. https://doi.org/10.1002/jhm.2578
8. Ghanbari Jolfaei, A., Makvandi, A., & Pazouki, A. (2014). Quality of sleep for hospitalized patients in Rasoul-Akram hospital. Medical Journal of the Islamic Republic of Iran, 28, 73.
9. Holleck, M. E., Tikkanen, K., Holleck, J. L., Frank, C., Falco, N., Cosentino, D., & Chang, J. J. (2023). Reducing nighttime interruptions and improving sleep for hospitalized patients by restructuring nighttime clinical workflow. Journal of General Internal Medicine, 38(9), 2091–2097. https://doi.org/10.1007/s11606-022-08005-2
10. Koshy, K., Gibney, M., O’Driscoll, D. M., Ogeil, R. P., & Young, A. C. (2024). Factors affecting sleep quality in hospitalised patients. Sleep and Breathing, 28(6), 2737–2740. https://doi.org/10.1007/s11325-024-03144-8
11. Kryger, M. H., Roth, T., & Dement, W. C. (2010). Principles and practice of sleep medicine (5th ed.). Elsevier Health Sciences.
12. 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, Article 8518396. https://doi.org/10.1155/2020/8518396
13. Lloyd, R., Munro, J., Evans, K., Gaskin-Williams, A., Hui, A., Pearson, M., Slade, M., Kotera, Y., Day, G., Loughlin-Ridley, J., Enston, C., & Rennick-Egglestone, S. (2023). Health service improvement using positive patient feedback: Systematic scoping review. PLoS ONE, 18(10), Article e0275045. https://doi.org/10.1371/journal.pone.0275045
14. Locihová, H., Jarošová, D., Šrámková, K., Slonkova, J., Zoubková, R., Maternová, K., & Sonka, K. (2025). Sleep quality of patients on a general department during the first days of hospitalization. Nature and Science of Sleep, 17, 505–515. https://doi.org/10.2147/NSS.S501743
15. Malini, H. S., Jothi, S., Jeyarani, D., & Sharma, R. (2023). A comparative study to assess the quality of sleep among hospitalized patients in wards and intensive care units at selected Apollo Hospitals. International Journal of Science Academic Research, 4(2), 5151–5154. http://www.scienceijsar.com
16. Morse, A. M., & Bender, E. (2019). Sleep in hospitalized patients. Clocks & Sleep, 1(1), 151–165. https://doi.org/10.3390/clockssleep1010014
17. Park, K. M., & Kyong, T. (2023). Disturbance of sleep and circadian rhythm in hospitalized patients. Chronobiology in Medicine, 5(1), 7–17. https://doi.org/10.33069/cim.2023.0003
18. Terp, R., Bergholt, M. D., Harboe, G., Herning, M., Noiesen, E., Szöts, K., Trosborg, I., & Konradsen, H. (2018). To sleep or not to sleep during hospitalisation: A mixed-method study of patient reported sleep quality and the experience of sleeping poorly during hospitalisation. Nordic Journal of Nursing Research, 38(1), 37–50. https://doi.org/10.18261/issn.1892-2686-2018-01-04
19. Thomas, K. P., Salas, R. E., Gamaldo, C., Chik, Y., Huffman, L., Rasquinha, R., & Gamaldo, A. (2012). Sleep rounds: A multidisciplinary approach to optimize sleep quality and satisfaction in hospitalized patients. Journal of Hospital Medicine, 7(6), 508–512. doi.org
20. 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
21. Zhang, J., Xiang, S., Li, X., Tang, Y., & Hu, Q. (2024). The impact of stress on sleep quality: A mediation analysis based on longitudinal data. Frontiers in Psychology, 15, Article 1431234. https://doi.org/10.3389/fpsyg.2024.1431234
22. Zhang, L., Yuan, Q., Wu, Q., & Kwauk, S. (2009). Sleep quality and sleep disturbing factors of inpatients in a Chinese general hospital. Journal of Clinical Nursing, 18(17), 2521–2529. https://doi.org/10.1111/j.1365-2702.2009.02846.x