Disturbed sleep in hospital: the answer is to treat patients like airline passengers

Public Health

By Tessa Hoffman

24 Jul 2018

Hospitalised patients have a poor night’s sleep on the wards – but the problem could be fixed with airline-style packs containing earplugs and eye masks, researchers suggest.

In what researchers believe is the first in-depth study on hospital sleep patterns, 2005 inpatients at 39 Dutch hospitals filled out questionnaires about the quality of their sleep on the ward the night before compared with usual sleep at home in the past month.

On average, patients reported having had 83 minutes less sleep during their night in the hospital than at home, waking 44 minutes earlier than their usual time with only 28% of patients waking up in the morning spontaneously.

They also had a more disturbed night – waking up 3.3 times on average compared to twice when they were at home.

The most common reasons for disturbed sleep were reported as noise from other patients, medical devices, pain and toilet visits.

But many of these factors “seem modifiable”, wrote Dr Hilde Wesselius from the Department of Internal Medicine at VU University Medical Center in Amsterdam and her co-authors in the paper published this month in JAMA Internal Medicine.

 “Continuous intravenous drips at night and extra diuretics may have contributed to an increased frequency of toilet visits in the hospital. Most of the sleep disturbing factors found in our study seem easy to address by incorporating simple changes in nightly hospital routines.”

Sleep is essential for adequate immune, metabolic and endocrine functioning and may have an association with healing and survival, they write.

“Future investigation on sleep optimisation should focus on interventions such as dimmed lights in corridors or patient rooms, silent footwear, remote alarms in staff rooms and in the pockets of the nurses, and distribution of flight packages at admission that contain earplugs and eye masks.”

Other suggestions include remote measurements of vital signs and nocturnal checkups via webcam and “minimising unnecessary standard procedures” like IV drips at night and routine vital sign measurements.

“However, to our knowledge most of these interventions have never been tested in general wards therefore prospective interventional studies are needed.”

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