Kontakt X:X | DOI: 10.32725/kont.2026.029

Sleep and delirium in hospitalized patients: a four-day multicenter cross-sectional study in general wardsNursing - Original article

Hana Locihová ORCID...1, 2, *, Karolína ©rámková ORCID...3, Jana Slonková ORCID...3, 4, Renáta Zoubková ORCID...1, 5, Klára Maternová ORCID...6, Darja Jaroąová ORCID...2
1 University of Ostrava, Faculty of Medicine, Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Ostrava, Czech Republic
2 University of Ostrava, Faculty of Medicine, Department of Nursing and Midwifery, Ostrava, Czech Republic
3 University Hospital Ostrava, Department of Neurology, Ostrava, Czech Republic
4 University of Ostrava, Faculty of Medicine, Department of Clinical Neurosciences, Ostrava, Czech Republic
5 University Hospital Ostrava, Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Ostrava, Czech Republic
6 Charles University, General University Hospital in Prague, First Faculty of Medicine, 2nd Department of Surgery - Department of Cardiovascular Surgery, Prague, Czech Republic

Introduction: Poor sleep quality is a risk factor for delirium in hospitalized patients.

Objective: To assess the association between subjective sleep quality and delirium, and to analyze pharmacotherapy during hospitalization.

Methods: A multicenter cross sectional study was conducted from June 2023 to March 2024 in seven general wards in the Czech Republic. The sample included 254 patients. Delirium was assessed daily using the Confusion Assessment Method short form. Sleep quality was evaluated on days 2 to 4 using the Richards-Campbell Sleep Questionnaire.

Results: Patients with delirium had longer hospital stays (8.25 vs 7.12 days), higher alcohol consumption (p < 0.001; tau = 0.242), and were more often admitted to medical wards (55.1%; p < 0.001; tau = 0.223). Total sleep scores were significantly lower in delirium patients, with the largest difference on night one (60.3 ± 26.2 vs 30.5 ± 23.9; p < 0.001). The total score showed the best discriminative ability (Youden index 0.369 and 0.279), whereas individual items were insufficient. Patients with delirium used more medications (p < 0.001), mainly antipsychotics and neuroleptics; benzodiazepines were not associated except clonazepam.

Conclusion: Delirium was associated with poorer sleep quality and higher antipsychotic use. Individual Richards-Campbell Sleep Questionnaire items showed limited ability to reliably distinguish sleep quality, particularly among delirium patients.

Keywords: Cross-Sectional Studies; Delirium; Hospitalization; Sleep; Surveys and Questionnaires
Grants and funding:

Supported by the Ministry of Health of the Czech Republic in cooperation with the Czech Health Research Council under project No. NU22-09-00457.

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: December 11, 2025; Revised: March 3, 2026; Accepted: April 8, 2026; Prepublished online: April 27, 2026 

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