Dataset Information

Sleep in Hospitalized Patients.

ABSTRACT: Hospitalized patients frequently have disordered and poor-quality sleep due to a variety of both intrinsic and extrinsic factors. These include frequent nighttime intrusions, insomnia related to pain and unfamiliar environments, dark conditions during the day with loss of natural light, and disruption of the natural sleep cycle due to illness. Sleep wake disturbances can result in a deleterious consequence on physical, emotional, and cognitive status, which may impact patient satisfaction, clinical recovery, and hospital length of stay. Despite this, clinicians frequently fail to document sleep disturbances and are generally unaware of the best practices to improve sleep quality in the hospital. A PubMed search was conducted using the terms: ("sleep and hospitalized patients") and ("sleep and hospitalization") to review the published data on the topic of sleep in hospitalized medical patients. The search was limited to English-language articles published between 2000 and 2018. Subsequent PubMed searches were performed to clarify the data described in the initial search, including the terms "hospital sleep protocols," "hospitalized patients sleep documentation," and "hospitalized patients sleep quality". The purpose of this review is to discuss sleep disturbances in hospitalized patients with a focus on causes of sleep disturbance, the effect of poor-quality sleep, high risk populations, considerations for surveillance and prevention, and pharmacologic and non-pharmacologic options for treatment.

SUBMITTER: Morse AM

PROVIDER: S-EPMC7509688 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Sleep in Hospitalized Patients.

Morse Anne Marie AM Bender Evin E

Clocks & sleep 20190225 1

Hospitalized patients frequently have disordered and poor-quality sleep due to a variety of both intrinsic and extrinsic factors. These include frequent nighttime intrusions, insomnia related to pain and unfamiliar environments, dark conditions during the day with loss of natural light, and disruption of the natural sleep cycle due to illness. Sleep wake disturbances can result in a deleterious consequence on physical, emotional, and cognitive status, which may impact patient satisfaction, clini ...[more]

PMID: 33089161

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Project description:ImportanceAlthough inadequate sleep has a proven negative association with health care outcomes, to date, no large-scale studies have examined sleep in general hospital wards.ObjectivesTo assess the subjective quantity and quality of sleep and to identify the hospital-related factors associated with sleep disturbances in hospitalized patients.DesignFor this nationwide, single-day, multicenter, cross-sectional, observational study, which took place on February 22, 2017, all hospitals in the Netherlands were encouraged by word of mouth and conventional and social media to participate in this study. A total of 39 hospitals participated. Included patients were at least 18 years of age, were able to give informed consent, and had spent at least 1 night in a regular-care hospital ward.ExposuresHospitalization in a regular-care ward.Main outcomes and measuresQuantity and quality of last night's sleep in the hospital compared with habitual sleep at home the month before hospitalization. The Consensus Sleep Diary and the Dutch-Flemish Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance item bank were used. Complementary questions assessed sleep-disturbing factors.ResultsA total of 2005 patients were included (median age, 68 years; interquartile range, 57-77 years; 994 of 1935 [51.4%] were male [70 patients did not identify their sex]). Compared with habitual sleep at home, the total sleep time in the hospital was 83 minutes (95% CI, 75-92 minutes; P < .001) shorter. The mean number of nocturnal awakenings was 2.0 (95% CI, 1.9-2.1) times at home vs 3.3 (95% CI, 3.2-3.5) times during hospitalization (P < .001). Patients woke up 44 minutes (95% CI, 44-45 minutes; P < .001) earlier than their habitual wake-up time at home. A total of 1344 patients (70.4%) reported having been awakened by external causes, which in 718 (35.8%) concerned hospital staff. All aspects of sleep quality measured using PROMIS questions were rated worse during hospitalization than at home. The most reported sleep-disturbing factors were noise of other patients, medical devices, pain, and toilet visits.Conclusions and relevanceThis study demonstrated that the duration and quality of sleep in hospitalized patients were significantly affected and revealed many potentially modifiable hospital-related factors negatively associated with sleep. Raising awareness about the importance of adequate sleep in the vulnerable hospital population and introducing interventions to target sleep-disturbing factors may improve healing.

Project description:Background:Data in the literature has shown poor sleep quality to be frequently observed in hospitalized patients and known to be associated with poor treatment outcome. Many factors may impact poor sleep quality, and there is currently limited available data. We aim to determine the prevalence of poor sleep quality and associated factors in patients admitted to internal medicine wards as well as the change of sleep quality over time after admission. Methods:An analytic observational study was conducted at the internal medicine wards at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Patients were personally interviewed to evaluate the history of sleep quality at home, sleep quality after the first and the third days of admission, and potential associated factors. The Pittsburgh Sleep Quality Index and screening questionnaires for the common diseases associated with poor sleep quality were also utilized. The logistic regression analysis was used to determine the independent factors which led to poor sleep quality. Results:Data were collected from 96 patients during the period of June 2015 to February 2016. The mean age of the patients was 50.8 ± 16.7 years, and 51% were male. Infectious disease was the most common principal diagnosis accounted for 29.2%. The results show high prevalence of poor sleep quality after the first night of admission compared to baseline sleep quality at home (50% vs. 18.8%; p < 0.001). After 3 days of admission, the prevalence of poor sleep quality was reduced to the level close to baseline sleep quality at home (28.1% vs. 18.8%; p = 0.13). Multivariate analysis demonstrated that light exposure and pain were the main independent factors for poor sleep quality on the first day (odds ratio 6.68; 95% CI 2.25-19.84) and on the third day (odds ratio 3.47; 95% CI 1.24-9.71), respectively. Conclusions:This is the first study conducted on the sleep quality of hospitalized patients that included the follow-up period during hospital admission. Our study demonstrated high prevalence of poor sleep quality in hospitalized patients on the first day. Interestingly, the sleep quality was partly improved during hospitalization. Light exposure and pain were demonstrated to be the factors associated with poor sleep quality.

Project description:BackgroundSleep is essential for recovery from illness. As a result, researchers have shown a growing interest in the sleep of hospitalized patients. Although many studies have been conducted over the past years, an up to date systematic review of the results is missing.ObjectiveThe objective of this systematic review was to assess sleep quality and quantity of hospitalized patients and sleep disturbing factors.MethodsA systematic literature search was conducted within four scientific databases. The search focused on synonyms of 'sleep' and 'hospitalization'. Papers written in English or Dutch from inception to April 25th,2022 were included for hospitalized patients >1 year of age. Papers exclusively reporting about patients receiving palliative, obstetric or psychiatric care were excluded, as well as patients in rehabilitation and intensive care settings, and long-term hospitalized geriatric patients. This review was performed in accordance with the PRISMA guidelines.ResultsOut of 542 full text studies assessed for eligibility, 203 were included, describing sleep quality and/or quantity of 17,964 patients. The median sample size of the studies was 51 patients (IQR 67, range 6-1472). An exploratory meta-analysis of the Total Sleep Time showed an average of 7.2 h (95%-CI 4.3, 10.2) in hospitalized children, 5.7 h (95%-CI 4.8, 6.7) in adults and 5.8 h (95%-CI 5.3, 6.4) in older patients (>60y). In addition, a meta-analysis of the Wake After Sleep Onset (WASO) showed a combined high average of 1.8 h (95%-CI 0.7, 2.9). Overall sleep quality was poor, also due to nocturnal awakenings. The most frequently cited external factors for poor sleep were noise and number of patients in the room. Among the variety of internal/disease-related factors, pain and anxiety were most frequently mentioned to be associated with poor sleep.ConclusionOf all studies, 76% reported poor sleep quality and insufficient sleep duration in hospitalized patients. Children sleep on average 0.7-3.8 h less in the hospital than recommended. Hospitalized adults sleep 1.3-3.2 h less than recommended for healthy people. This underscores the need for interventions to improve sleep during hospitalization to support recovery.

Project description:ObjectivesDespite the known adverse effects of sleep deprivation on recovery from illness, studies have shown that sleep deprivation remains an incompletely addressed problem among acutely ill inpatients. Behavioral interventions are recommended as first-line therapy prior to using pharmacologic therapy due to the side effects of sedative hypnotics. The objective of this systematic review was to identify non-pharmacologic interventions that have been used to improve sleep quality and quantity of non-intensive care unit (ICU) inpatients.Data sourcesPubMed, Embase, Web of Science, CINAHL, and Cochrane Library through January 2013; manual searches of reference lists.Study eligibility criteria, participants, interventionsAny study in which a non-pharmacologic intervention was conducted in a general inpatient setting, and nighttime sleep quantity or quality was assessed.Study appraisal and synthesis methodsInformation on study design, populations, interventions, comparators, outcomes, time frame, and risk of bias were independently abstracted by two investigators.Results13 intervention studies with 1,154 participants were included. Four studies were randomized controlled trials. Seven studies had a low to medium risk of bias, and there was significant heterogeneity in the interventions. Relaxation techniques improved sleep quality 0-38%, interventions to improve sleep hygiene or reduce sleep interruptions improved sleep quantity 5%, and daytime bright light exposure improved sleep quantity 7-18%.LimitationsThe heterogeneity in the types and dose of interventions, outcome measures, length of follow-up, differences in patient populations, and dearth of randomized trials may dilute effects seen or make it more difficult to draw conclusions.Conclusions and implications of key findingsThere is insufficient to low strength of evidence that any non-pharmacologic intervention improves sleep quality or quantity of general inpatients. Further studies are needed in this area to guide clinicians.

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Sleep in Hospitalized Patients.

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Sleep in Hospitalized Patients.

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