Improving inpatient environments to support patient sleep

DuBose, Jennifer; Hadi, Khatereh

doi:10.1093/intqhc/mzw079

Cited by 70 publications

(67 citation statements)

References 60 publications

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“…Nonpharmacological alternatives such as providing ear plugs and eye masks, changing the light and sound environment, and reducing nursing care activities that disrupt sleep as a first line treatment for transient sleep disturbances in the hospital environment can reduce the number of patients who experience sleep‐inducing drugs for the first time in the hospital. Whether these strategies can also reduce the number of individuals who become long‐term hypnosedative drug users in old age and how it is possible to reduce the patient wish to continue sleep‐inducing drugs after discharge should be topics for future research.…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported factors associated with the desire to continue taking sleep‐inducing drugs after hospital discharge: A survey of older adults

Heinemann

Neukirchen

Nau

et al. 2019

Pharmacoepidemiology and Drug

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Purpose To find out whether any prior experiences with sleep‐inducing drugs before hospitalization and positive experiences with these drugs during hospitalization influence a patient's wish to continue taking sleep‐inducing drugs after hospitalization. Methods We surveyed older hospital patients about use of sleep‐inducing drugs before, during, and after hospitalization and compared these answers with their hospital chart using the kappa statistic. The association between the wish to continue these drugs after discharge and the perceived benefits, experience of side effects, and prior experience with sleep‐inducing drugs was determined by multivariable logistic regression. Results Agreement between patient responses and the hospital file was high (κ = 0.7). Seventeen percent (83/483) of the participants reported prior experience before their hospital stay; 45% received a sleep‐inducing drug during hospitalization; 17% wished to continue taking them after discharge. Of the 400 patients who had no prior experience with sleep‐inducing drugs, 147 (37%) became first‐time users in the hospital, and 27% (40/147) of these wished to continue this medication after discharged. Strong predictors for this wish were the reduction of sleep onset problems (adjusted odds ratio, 6.26; 95% confidence interval, 2.38‐16.44) and any prior experience with sleep‐inducing drugs (4.08; 1.97‐8.48). Conclusions Many older patients become first‐time users of sleep‐inducing drugs in the hospital. Especially the experience of sleep onset improvements influences the wish to continue sleep‐inducing drug use after discharge. Avoiding first‐time use should become a goal of hospital policy and be taken into account when weighing the benefits and risks of sleep‐inducing drugs.

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Section: Discussionmentioning

confidence: 99%

Patient‐reported factors associated with the desire to continue taking sleep‐inducing drugs after hospital discharge: A survey of older adults

Heinemann

Neukirchen

Nau

et al. 2019

Pharmacoepidemiology and Drug

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“…Previous studies demonstrated the effectiveness of using eye mask in improving sleep quality in hospitalized patients in general medical wards, post anesthesia care units as well as in intensive care units [33][34][35]. A review also demonstrated that changing the sound and light environment appeared to be effective in improving sleep in hospitals [36]. Great variance of the sleep outcome reported, multitude of independent variables, and outcome metrics of the current available studies made it difficult to conclude.…”

Section: Sleep Disordersmentioning

confidence: 99%

Sleep Quality of Hospitalized Patients, Contributing Factors, and Prevalence of Associated Disorders

et al. 2020

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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.

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“…[3][4][5][6][7][8][9][10] Fortunately, some recent interventions have been proposed to improve sleep quality during hospitalization and have shown promising results. 11 No data are currently available on subjective sleep quality in the emergency department (ED). The main objective of this study was to assess the subjective quality of patient nighttime sleep in the ED and its associated factors.…”

Section: Introductionmentioning

confidence: 99%

Subjective sleep quality and its etiology in the emergency department

Paquet

Carrier

Lavigne

et al. 2018

CJEM

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CLINICIAN'S CAPSULE What is known about the topic? Most hospital settings do not provide an optimal environment for sleep. What did this study ask? Assessed the subjective quality of nighttime sleep and its affecting factors in the emergency department (ED). What did this study find? Subjective sleep quality was lower in the ED, as compared with home sleep, and was affected by stress, noise, pain, and stretcher comfort. Why does this study matter to clinicians? ED sleep is not optimal but can be improved, as the factors disturbing it are potentially modifiable.

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Improving inpatient environments to support patient sleep

Abstract: The research is hard to consolidate due to the multitude of independent variables and outcome metrics, but overall points to the potential for making meaningful improvements in the quality of patient sleep.

Cited by 70 publications

References 60 publications

Patient‐reported factors associated with the desire to continue taking sleep‐inducing drugs after hospital discharge: A survey of older adults

Patient‐reported factors associated with the desire to continue taking sleep‐inducing drugs after hospital discharge: A survey of older adults

Sleep Quality of Hospitalized Patients, Contributing Factors, and Prevalence of Associated Disorders

Subjective sleep quality and its etiology in the emergency department

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