Pilot study aiming to support sleep quality and duration during hospitalizations. Issue 7 (11th March 2016) - Gathecha, Evelyn
Abstract : BACKGROUND: Sleep is a vital part to healing and recovery, hence poor sleep during hospitalizations is highly undesirable. Few studies have assessed interventions to optimize sleep among hospitalized patients. OBJECTIVE: To assess the effect of sleep‐promoting interventions on sleep quality and duration among hospitalized patients. DESIGN: Quasi‐experimental prospective study. SETTING: Academic medical center. PARTICIPANTS: Adult patients on the general medicine ward. INTERVENTION: Nurse‐delivered sleep‐promoting interventions augmented by sleep hygiene education and environmental control to minimize sleep disruption. MEASUREMENTS: Objective and subjective measurement of sleep parameters using validated sleep questionnaires, daily sleep diary, and actigraphy monitor. RESULTS: Of the 112 patients studied, the mean age was 58 years, 55% were female, the mean body mass index was 32, and 43% were in the intervention group. Linear mixed models tested mean differences in 7 sleep measures and group differences in slopes representing nightly changes in sleep outcomes over the course of hospitalization between intervention and control groups. Only total sleep time, computed from sleep diaries, demonstrated significant overall mean difference of 49.6 minutes (standard error [SE] = 21.1, P < 0.05). However, significant differences in average slopes of subjective ratings of sleep quality (0.46, SE = 0.18, P < 0.05), refreshing sleep (0.54, SE = 0.19, P < 0.05), and sleep interruptions (−1.6, SE = 0.6, P < 0.05) indicated improvements during hospitalization within intervention patients compared to controls. CONCLUSION: This study demonstrated that there is an opportunity to identify patients not sleeping well in the hospital. Sleep‐promoting initiatives, both at the unit level as well as individualized offerings, may improve sleep during hospitalizations, particularly over the course of the hospitalization. Journal of Hospital Medicine 2016;11:467–472. © 2016 Society of Hospital Medicine