How to Improve Patients' Perceived Quality of Sleep During Hospitalization Through a Multicomponent “Good Sleep Bundle”: A Prospective Before and After Controlled Study

Abstract

Introduction Despite sound evidence on the importance of sleep for human beings and its role in healing, hospitalized patients still experience sleep disruption with deleterious effects. Many factors affecting patients' sleep can be removed or minimized. We evaluated the efficacy of a multicomponent Good Sleep Bundle (GSB) developed to improve patients' perceived quality of sleep, through which we modified environmental factors, timing of nighttime clinical interventions, and actively involved patients in order to positively influence their experience during hospitalization. Methods: In a prospective, before and after controlled study, two different groups of 65 patients each were admitted to a cardiothoracic unit in two different periods, receiving the usual care (control group) and the GSB (GSB group), respectively. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) at the admission, discharge, and 30 days after discharge in all patients enrolled. Comparisons between the two groups evaluated changes in PSQI score from admission to discharge (primary endpoint), and from admission to 30 days after discharge (secondary endpoint). Results: The mean PSQI score difference between admission and discharge was 4.54 (SD 4.11) in the control group, and 2.05 (SD 4.25) in the GSB group. The mean difference in PSQI score change between the two groups, which was the primary endpoint, was 2.49 (SD 4.19). This difference was highly significant (p = 0.0009). Conclusion: The GSB was associated with a highly significant reduction of the negative effects that hospitalization produces on patients' perceived quality of sleep compared with the usual care group.

Bibliometric Analysis of the Top-100 Cited Articles on Postoperative Sleep During the Last 10 Years

“…This study clued that WeChat-based multimodal nursing program was beneficial for the improvement of postoperative sleep quality and early postoperative rehabilitation. Other non-pharmacological methods, such as multicomponent Good Sleep Bundle, sleep package including an eye mask, earplugs, lavender scent pad, and non-caffeinated tea also shows benefits in postoperative sleep [12,21]. However, according to the analyses of keywords, non-pharmacological therapy has not led to a significant influence in this field.…”

“…A number of measures to relieve postoperative sleep disorders have been prompted in the last decades. One the one hand, nonpharmacological methods include reducing the noise and light of the wards, avoiding interruptions at night, and sleep aid devices [11][12][13]. On the other hand, hypnotics and sedatives are frequently used to improve sleep quality.…”