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How to minimize sleep disruption in hospitalized patients
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Compared with habitual sleep at home, sleep duration and quality were significantly worse in the hospital, according to findings published in JAMA Internal Medicine.
The authors note that modifiable factors, such as introducing earplugs, can help to reduce sleep disturbances in hospitalized patients.
“Although inadequate sleep has a proven negative association with health care outcomes, to date, no large-scale studies have examined sleep in general hospital wards,” Hilde M. Wesselius, MD, from VU University Medical Center, the Netherlands, and colleagues wrote.
Wesselius and colleagues conducted a single-day observational study across 39 hospitals in the Netherlands to investigate the quantity and quality of sleep that patients receive in the hospital and the factors associated with sleep disturbances.
The researchers used data from the Consensus Sleep Diary and the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Sleep Disturbance questionnaires to compare sleep at the hospital with habitual sleep at home the month before hospitalization. Approximately 2,000 patients aged 18 years or older who spent at least 1 night in a regular care hospital ward completed the questionnaires (median age, 68 years; 51.4% men).
The study revealed that total sleep time was 83 minutes shorter in the hospital than at home. Participants had more nocturnal awakenings during hospitalization than at home (mean, 3.3 vs. 2). Compared with their habitual wake-up time at home, hospitalized patients woke up 44 minutes earlier.
Most participants (70.4%) reported being awakened by external causes, 35.8% of which were related to hospital staff. Participants rated all aspects of sleep quality as worse during hospitalization compared with sleep at home. Noise from other patients, medical devices, pain and toilet visits were the most commonly reported sleep-disturbing factors.
Prabath W. B. Nanayakkara , MD, PhD, senior author of the study, also from VU University Medical Center, told Healio Internal Medicine that hospitalists need to be more aware that patients are not getting adequate sleep and that there are factors they can modify to help them get more sleep.
He noted that introducing earplugs, eye masks and more comfortable mattresses and pillows may help to improve sleep and increase awareness about sleep in the hospital setting.
Nanayakkara suggested that hospitalists avoid measurements of routine vital parameters early in the morning, stop the IV drips around 10:00 p.m. and not give diuretics after around 4:00 p.m., if possible.
“Hospitalists must also educate patients about the importance of day and night rhythm and adapt the routine practices to patients’ rhythm rather than expecting patients to adapt to the hospital rhythm,” Nanayakkara said. – by Alaina Tedesco
Disclosure: The authors report no relevant financial disclosures.