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.

Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

“…Despite the fact that only a relatively reduced percentage of patients will require hospitalisation during acute COVID-19 infection, significant importance must be placed on sleep deficiencies in relation to hospitalisation. It is well known at this point that both sleep time [ 11 , 107 ] and quality [ 11 , 107 , 108 ] are affected by hospitalisation in both adult [ 11 , 107 , 108 ] and paediatric patients [ 11 ]. Sleep-disturbing elements can be grouped as extrinsic (noise, irregular exposure to lights, bright lights alerted bedtime routine, clinical interventions, etc.)…”

“…Multiple terms can be used to describe the reduction in sleep time or to at least include a reduction in sleep duration: sleep deprivation, sleep loss, sleep deprivation/insufficient sleep syndrome [ 7 , 8 ], sleep insufficiency [ 9 ], or broader terms such as sleep deficiency [ 10 ], sleep wake disfunction [ 11 ]. Although there are subtle differences between these terms, occasionally they are used interchangeably in the literature.…”

Sleep improvement intervention and its effect on patients’ sleep on the ward

“…Existing evidence suggests that patients sleep poorly during hospitalisation (Delaney et al, 2018;Gellerstedt et al, 2014;Morse & Bender, 2019). It is well known that hospital wards are not ideal places for resting, and the poor quality of sleep during hospitalisation may even lead to further sleep problems at home (Bernhofer et al, 2014;MacFarlane et al, 2019).…”

Sleep promotion for hospitalised children: Developing an evidence-based guideline for nurses

“…Sleep regulates vital signs (Dennis et al 2010 ), improves immunity and supports recovery from illness and injury (DeKeyser Ganz 2012 ; Gamaldo, Shaikh & McArthur 2012 ). Ill-health, some medications and pre-existing sleep dysfunctions all have a negative impact on the duration and quality of sleep of patients in hospitals (Herbert et al 2014 ; Morse & Bender 2019 ).…”

“…In critically ill adults, length of stay is adversely affected by in-hospital sleep disruption (Morse & Bender 2019 ). Sleep in hospitalised children is disrupted by an unfavourable environment that prioritises disease management above sleep (Bevan et al 2019 ; Setoyama, Ikeda & Kamibeppu 2016 ; Stickland et al 2016 ), evidenced by a quantitative loss of more than one hour sleep per night during hospitalisation (Bevan et al 2019 ).…”