Tuesday Jul 17, 2018
Hospital patients get a lot less sleep, wake up more frequently during the night, and rise earlier in the morning than they would in bed at home, a Dutch study suggests.
While previous research has also tied sleep problems in hospitals to worse outcomes for patients, few studies to date have quantified exactly how little rest patients get, researchers note in JAMA Internal Medicine.
For the current study, researchers examined data collected from about 2,000 adults who spent a night at one of 39 hospitals in the Netherlands.
Overall, patients slept an average of 83 minutes less that night in the hospital than they typically did at home, and they also woke up an average of 44 minutes earlier in the morning, the study found.
This might not seem surprising because people typically woke up three times a night in the hospital, compared with twice a night at home.
“The most reported sleep-disturbing factors were noise of other patients, medical devices, pain, and toilet visits,” according to the researchers.
But doctors, nurses, and noises were not the only things patients blamed for their lack of sleep.
“Patients could not sleep because they were for example worried about their spouse who is demented and who is home alone, or about their dog or other pets, or they were worried about whether they could attend the upcoming wedding of their daughter,” said senior study author Dr. Prabath Nanayakkara of VU University Medical Center in Amsterdam.
“Most of the time they had not spoken to the hospital staff about this,” Nanayakkara said by email.
More than two-thirds of patients in the survey said they were awakened by external causes, but just 36 percent of them alerted hospital staff, the study found.
Half of the patients in the study were at least 68 years old and most of them had been in the hospital for more than the one night of the study.
While about 26 per cent of them had a private room, 26 per cent had one roommate and 41 per cent had three or more roommates - but the number of patients sleeping the same room didn’t seem to affect sleep quality.
A total of 335 patients, or 17 per cent, had been taking medications at home to help them sleep
Sleep disturbances at home didn’t differ by age group, but in the hospital older patients experienced less disturbances than younger patients.
The study wasn’t a controlled experiment designed to prove whether or how hospitalization impacts the quality or quantity of sleep, and it didn’t examine how sleep outcomes might impact other health outcomes for patients.
Still, the negative health impact of poor sleep is well documented, said Dr. Sharon Inouye, author of an accompanying editorial and director of the Aging Brain Center at Hebrew SeniorLife in Boston.
“There are many effects - perhaps the most well recognized is that cognitive functions (like attention and memory) get disrupted,” Inouye said by email. It can also lead to inflammation in the brain and disruptions to hormones in the body that interfere with health and healing.
The fix is to simply leave patients in peace so they can sleep, Inouye advised.
“Stop waking patients up - give an uninterrupted period for sleep at night,” Inouye said. “This would have tremendous benefits.”
Patients and families can speak up when they feel that staff are waking them up too much, and they can also consider using earplugs or eye masks to make conditions more conducive to a good night’s rest, Inouye advised.
“All staff are so busy and so many things to get done, that minimizing awakenings for patients at night is not prioritized,” Inouye said.