Sleep rounds: A multidisciplinary approach to optimize sleep quality and satisfaction in hospitalized patients

Thomas, Katherine P.; Salas, Rachel E.; Gamaldo, Charlene E.; Chik, Yolanda; Huffman, Linda; Rasquinha, Russell J.; Hoesch, Robert E.

doi:10.1002/jhm.1934

Cited by 37 publications

(58 citation statements)

References 25 publications

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“…There are both intrinsic and extrinsic factors that contribute to development of SWD during hospitalization 3,[18][19][20] . Intrinsic factors vary by patient, but can include primary medical illness, delirium, psychiatric co-morbidity (anxiety, depression, post-traumatic stress), pre-existing SD and physical pain or discomfort 1,2,21,22 . Pain and discomfort are generally the most frequently cited causes of SWD during hospitalization 1 .…”

Section: Sleep Wake Dysfunction In Hospitalized Patientsmentioning

confidence: 99%

“…Environmental noise can be due to equipment/alarms, medical staff, or hospital roommates. Roommates are commonly reported as the most disturbing factor for sleep 1 . A study evaluating acceptable environmental noise levels found that daytime noise of 59 decibel A (dBA) and nighttime noise of 50.5 dBA did not result in SWD.…”

Section: Sleep Wake Dysfunction In Hospitalized Patientsmentioning

confidence: 99%

“…Sleep wake disorders can result in deleterious consequence on physical, emotional and cognitive status, which may contribute to impaired recovery, prolonged length of stay, reduced subjective wellness and poor patient perception of hospitalized care 1,2,22,28 . SWD and sleep deprivation have numerous deleterious effects (Figure 1), including autonomic dysfunction, impairment of the hypothalamic-pituitary-adrenal axis, and immunologic dysregulation 29 .…”

Section: Effects Of Swd In Hospitalized Patientsmentioning

confidence: 99%

“…Sleep is a homeostatic process that contributes to maintenance of health, cognition and mood stability. 1,2 Normal sleep in an adult generally is about 7-9 hours per night and consists of [4][5][6] minute cycles between non-rapid eye movement (REM) and REM sleep. 3 Sleep wake dysfunction (SWD) refers to the disruption of the normal sleep wake relationship that can lead to the development of a transient or chronic sleep wake disorder (SD).…”

Section: Introductionmentioning

confidence: 99%

“…2 For instance, insufficient sleep, with an average of 5 hours of sleep per night, with multiple night time awakenings had been found in adult patients in a neurologic ward. 1 There is a suggestion that the higher the acuity of illness the greater the impact on sleep. For example, pediatric patients in intensive care unit can experience up to a 54 percent reduction in sleep hours, while children in the general pediatric unit have been reported to have a 20-25 percent sleep loss.…”

Section: Introductionmentioning

confidence: 99%

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Sleep in Hospitalized Patients

Morse

Bender

2018

Preprint

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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 natural sleep cycle due to illness. Sleep wake disturbances can result in 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 best practices to improve sleep quality in the hospital. The purpose of this review is to discuss sleep disturbances in hospitalized patients with a focus on causes of sleep disturbance, effect of poor quality sleep, high risk populations, considerations for surveillance and prevention, as well as pharmacologic and non-pharmacologic options for treatment.

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Section: Sleep Wake Dysfunction In Hospitalized Patientsmentioning

confidence: 99%

Section: Sleep Wake Dysfunction In Hospitalized Patientsmentioning

confidence: 99%

Section: Effects Of Swd In Hospitalized Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sleep in Hospitalized Patients

Morse

Bender

2018

Preprint

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Evaluation of Nonpharmacologic Interventions and Sleep Outcomes in Hospitalized Medical and Surgical Patients

et al. 2022

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ImportanceInadequate sleep negatively affects patients' physical health, mental well-being, and recovery. Nonpharmacologic interventions are recommended as first-choice treatment. However, studies evaluating the interventions are often of poor quality and show equivocal results.ObjectiveTo assess whether the implementation of nonpharmacologic interventions is associated with improved inpatient night sleep.Design, Setting, and ParticipantsIn a nonrandomized controlled trial, patients were recruited on the acute medical unit and medical and surgical wards of a Dutch academic hospital. All adults who spent exactly 1 full night in the hospital were recruited between September 1, 2019, and May 31, 2020 (control group), received usual care. Patients recruited between September 1, 2020, and May 31, 2021, served as the intervention group. The intervention group received earplugs, an eye mask, and aromatherapy. Nurses received sleep-hygiene training, and in the acute medical unit, the morning medication and vital sign measurement rounds were postponed from the night shift to the day shift. All interventions were developed in collaboration with patients, nurses, and physicians.Main Outcomes and MeasuresSleep was measured using actigraphy and the Dutch-Flemish Patient-Reported Outcomes Measurement Information System sleep disturbance item bank. Other outcomes included patient-reported sleep disturbing factors and the use of sleep-enhancing tools.ResultsA total of 374 patients were included (222 control, 152 intervention; median age, 65 [IQR, 52-74] years). Of these, 331 were included in the analysis (195 [59%] men). Most patients (138 [77%] control, 127 [84%] intervention) were in the acute medical unit. The total sleep time was 40 minutes longer in the intervention group (control: median, 6 hours and 5 minutes [IQR, 4 hours and 55 minutes to 7 hours and 4 minutes]; intervention: 6 hours and 45 minutes [IQR, 5 hours and 47 minutes to 7 hours and 39 minutes]; P < .001). This was mainly due to a 30-minute delay in final wake time (median clock-time: control, 6:30 am [IQR, 6:00 am to 7:22 am]; intervention, 7:00 am [IQR, 6:30-7:30 am]; P < .001). Sleep quality did not differ significantly between groups. For both groups, the main sleep-disturbing factors were noises, pain, toilet visits, and being awakened by hospital staff. Sleep masks (23 of 147 [16%]) and earplugs (17 of 147 [12%]) were used most. Nightly vital sign checks decreased significantly (control: 54%; intervention: 11%; P < .001).Conclusions and RelevanceThe findings of this study suggest that sleep of hospitalized patients may be significantly improved with nonpharmacologic interventions. Postponement of morning vital sign checks and medication administration rounds from the night to the day shift may be a useful way to achieve this.Trial RegistrationNetherlands Trial Registry Identifier: NL7995

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Pilot study aiming to support sleep quality and duration during hospitalizations

Gathecha

Rios

Buenaver

et al. 2016

Journal of Hospital Medicine

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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

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Sleep rounds: A multidisciplinary approach to optimize sleep quality and satisfaction in hospitalized patients

Abstract: BACKGROUND: Poor sleep has adverse affects on heath, yet few studies have addressed the goal of improving sleep among hospitalized patients. We evaluated the effectiveness of a sleep-promoting intervention on the quality and quantity of sleep among inpatients.

Cited by 37 publications

References 25 publications

Sleep in Hospitalized Patients

Sleep in Hospitalized Patients

Evaluation of Nonpharmacologic Interventions and Sleep Outcomes in Hospitalized Medical and Surgical Patients

Pilot study aiming to support sleep quality and duration during hospitalizations

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