Rapid Clinical Updates: No Rest for the Admitted: Tackling Insomnia in the Hospital-Handout

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Insomnia is highly prevalent among hospitalized patients, with inpatients sleeping approximately two hours less than normal. Multiple factors contribute to poor inpatient sleep, many of which may be modifiable through hospitalist-led interventions. Improving sleep quality in the hospital setting can enhance recovery and increase patient satisfaction.<br /><br />Pharmacologic sleep aids are frequently used to help patients rest, but evidence supporting their benefit is limited and of low quality. These medications carry risks, including an increased likelihood of falls, especially in older adults. As a result, non-pharmacologic approaches to improving sleep are safer, effective, and generally preferred over drug therapy.<br /><br />Environmental disruptions like frequent vital checks, diagnostic tests, and noise are significant contributors to poor inpatient sleep. Staff-driven interventions that minimize overnight interruptions, reduce room entries, and lower noise levels have proven to be effective in enhancing sleep quality. Notably, improvements have been observed even in units without targeted interventions, suggesting that small cultural shifts can yield significant outcomes.<br /><br />Patients themselves can be empowered to improve their sleep hygiene during hospitalization. Reducing afternoon caffeine intake and daytime naps, using sleep aids like earplugs and eye masks, and maintaining consistent nighttime routines can facilitate better sleep. Hospitalists can play a key role in promoting sleep-friendly practices by optimizing ordering processes, fostering patient empowerment, and addressing environmental factors.<br /><br />In summary, addressing inpatient insomnia requires a multifaceted approach prioritizing non-pharmacologic strategies, environmental optimization, and patient engagement. Such measures are likely to promote better recovery, reduce adverse effects associated with sleep medications, and improve overall patient satisfaction during hospital stays.

Keywords

insomnia

hospitalized patients

inpatient sleep

hospitalist interventions

pharmacologic sleep aids

non-pharmacologic approaches

environmental disruptions

sleep hygiene

patient empowerment

sleep quality improvement