Optimizing Sleep in the Hospital Setting-Slides

Slides

Pdf Summary

This presentation by Dr. Nancy H. Stewart focuses on the importance of sleep in hospitalized patients, examining its impact on health, existing evidence, gaps in research, and opportunities for improvement. Sleep is critical for recovery from acute illness, yet patients typically experience about two hours less sleep in the hospital versus at home, with noise, pain, medications, tests, and vital sign checks identified as major disruptors. These sleep disturbances contribute to adverse outcomes like delirium, cardiometabolic problems (e.g., hyperglycemia, hypertension), functional decline, increased readmissions, and hospital-acquired complications such as infections and falls.<br /><br />Actigraphy and sound monitoring reveal hospital environments have noise levels far exceeding WHO recommendations, significantly reducing sleep duration especially in patients with preexisting sleep disorders, including obstructive sleep apnea (OSA) and insomnia—conditions common among inpatients. Sleep loss exacerbates delirium risk, worsens blood pressure control, and increases odds of hyperglycemia, adversely affecting recovery.<br /><br />Efforts to improve sleep include behavioral and systemic interventions like the SIESTA program, which promotes screening for sleep disorders, patient sleep hygiene education, eliminating unnecessary awakenings, noise reduction, and proper symptom management. Changing hospital culture by adjusting default timing for labs and medications, limiting overnight vital checks, and using electronic health record "nudges" show promise in reducing nighttime disruptions. Avoiding sedative sleep aids is recommended due to risks of falls.<br /><br />Healthcare workers also face significant sleep disruption, impacting performance and patient safety; strategies for their sleep health are advised.<br /><br />The presentation concludes that improving inpatient sleep via targeted interventions and culture change can potentially reduce morbidity and healthcare utilization, calling for further research and institutional commitment to sleep-friendly hospital practices.

Keywords

hospitalized patient sleep

sleep disruption

health outcomes

delirium

cardiometabolic complications

hospital noise levels

sleep disorders inpatients

SIESTA program

sleep hygiene education

hospital culture change