Sleep Histories Are Seldom Documented on a General Medical Service

Am, Namen; Sh, Landry; Ld, Case; McCall, W. Vaughn; Dp, Dunagan; Ef, Haponik

doi:10.1097/00007611-200194090-00008

Cited by 26 publications

(4 citation statements)

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“…This low rate would result in a lower number of treated older adults being included in studies. Staff in regular sleep laboratories do not specialise in geriatric patients and, therefore, may not be able to cope with the extended nursing needs of the elderly, and especially that frail elderly [4,19]. Home testing of geriatric patients might make these studies more feasible.…”

Section: Discussionmentioning

confidence: 99%

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Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

et al. 2016

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Sleep disordered breathing (SDB) is a leading cause of morbidity worldwide. Its prevalence increases with age. Due to the demographic changes in industrial societies, pulmonologists and sleep physicians are confronted with a rapidly growing number of elderly SDB patients. For many physicians, it remains unclear how current guidelines for SDB management apply to elderly and frail elderly patients. The goal of this consensus statement is to provide guidance based on published evidence for SDB treatment in this specific patient group.Clinicians and researchers with expertise in geriatric sleep medicine representing several countries were invited to participate in a task force. A literature search of PubMed from the past 12 years and a systematic review of evidence of studies deemed relevant was performed.Recommendations for treatment management of elderly and frail elderly SDB patients based on published evidence were formulated via discussion and consensus.In the last 12 years, there have been surprisingly few studies examining treatment of SDB in older adults and even fewer in frail older adults. Studies that have been conducted on the management of SDB in the older patient population were rarely stratified for age. Studies in SDB treatment that did include age stratification mainly focused on middle-aged and younger patient groups. Based on the evidence that is available, this consensus statement highlights the treatment forms that can be recommended for elderly SDB patients and encourages treatment of SDB in this large patient group. @ERSpublications An overview of the research in the field of and clinical guidelines for the treatment of SDB in elderly patients

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Section: Discussionmentioning

confidence: 99%

“…Despite the high prevalence of SDB in the older populations, the condition is frequently unrecognised and undiagnosed even in geriatric settings [18,19]. Unfortunately, many older patients who do seek medical attention for SDB are dismissed as having no significant illness without formal assessment.…”

Section: Introductionmentioning

confidence: 99%

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

et al. 2016

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“…One study performed on the general medical ward of a Veteran's Affairs hospital found that although 23% of patients admitted had a significant sleep symptom, there was no medical record during their admission documenting sleep symptoms [76]. Another study performed on a general medical floor at a non-profit academic hospital found that sleep histories were documented on only 9% of hospital charts, despite 68% of patients having conditions associated with obstructive sleep apnea (hypertension, obesity, stroke, and prior myocardial infarction) [77].…”

Section: Physician Surveillance Of Swdmentioning

confidence: 99%

Sleep in Hospitalized Patients

Morse

Bender

2019

Clocks & Sleep

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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.

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“…But although many may share the impression that insomnia is under-recognized by clinicians [ 7 , 8 ], the actual data available from medical practice is limited and ambiguous. Two studies have confirmed that sleep is seldom documented in medical charts in general hospitals [ 9 ] or on general medical services [ 10 ], whereas a recent large-scale study concluded that sleep disturbance is adequately recognized by general practitioners [ 11 ]. Only one study has been conducted to test if sleep disturbance is clinically recognized in patients with mental disorders [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Differences between patients' and clinicians' report of sleep disturbance: a field study in mental health care in Norway

et al. 2011

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BackgroundThe aims of the study was to assess the prevalence of diagnosed insomnia and the agreement between patient- and clinician-reported sleep disturbance and use of prescribed hypnotic medication in patients in treatment for mental disorders.MethodsWe used three cross-sectional, multicenter data-sets from 2002, 2005, and 2008. Data-set 1 included diagnostic codes from 93% of all patients receiving treatment in mental health care in Norway (N = 40261). Data-sets 2 (N = 1065) and 3 (N = 1181) included diagnostic codes, patient- and clinician-reported sleep disturbance, and use of prescribed hypnotic medication from patients in 8 mental health care centers covering 10% of the Norwegian population.Results34 patients in data-set 1 and none in data-sets 2 and 3 had a diagnosis of insomnia as a primary or comorbid diagnosis. In data-sets 2 and 3, 42% and 40% of the patients reported sleep disturbance, whereas 24% and 13% had clinician-reported sleep disturbance, and 7% and 9% used hypnotics. Patients and clinicians agreed in 29% and 15% of the cases where the patient or the clinician or both had reported sleep disturbance. Positive predictive value (PPV) of clinicians' evaluations of patient sleep disturbance was 62% and 53%. When the patient reported sleep disturbance as one of their most prominent problems PPV was 36% and 37%. Of the patients who received hypnotic medication, 23% and 29% had neither patient nor clinician-rated sleep disturbance.ConclusionWhen patients meet the criteria for a mental disorder, insomnia is almost never diagnosed, and sleep disturbance is imprecisely recognized relative to the patients' experience of sleep disturbance.

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Sleep Histories Are Seldom Documented on a General Medical Service

Cited by 26 publications

References 0 publications

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

Sleep in Hospitalized Patients

Differences between patients' and clinicians' report of sleep disturbance: a field study in mental health care in Norway

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