Wesselius HM, et al. - In this nationwide, single-day, multicenter, cross-sectional, observational study, which took place on February 22, 2017, the researchers evaluated the subjective quantity and quality of sleep as well as identified the hospital-related factors associated with sleep disturbances in hospitalized patients. They found that the duration and quality of sleep in hospitalized subjects were significantly affected and showed many potentially modifiable hospital-related factors negatively associated with sleep. Findings suggested that bringing issues to light about the importance of adequate sleep in the vulnerable hospital population and introducing interventions to target sleep-disturbing factors might improve healing. The noise of other patients, medical devices, pain, and toilet visits were the most reported sleep-disturbing factors.

Methods

• For this investigation, all hospitals in the Netherlands were encouraged by word of mouth and conventional and social media to partake.
• Thirty-nine hospitals took an interest in this analysis.
• Eligibility criteria included patients who were at least 18 years of age, were able to give informed consent, and had spent at least 1 night in a regular-care hospital ward.
• Hospitalization in a regular-care ward was the main exposure.
• Researchers analyzed quantity and quality of last night's sleep in the hospital compared with habitual sleep at home the month before hospitalization.
• They used the Consensus Sleep Diary and the Dutch-Flemish Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance item bank.
• Complementary questions evaluated sleep-disturbing factors.

Results

• Two thousand, five patients were involved (median age, 68 years; interquartile range, 57-77 years; 994 of 1935 [51.4%] were male [70 patients did not identify their sex]).
• It was observed that the total sleep time in the hospital was 83 minutes (95% CI, 75-92 minutes; P < .001) shorter compared with habitual sleep at home.
• Findings revealed that the mean number of nocturnal awakenings was 2.0 (95% CI, 1.9-2.1) times at home vs 3.3 (95% CI, 3.2-3.5) times during hospitalization (P < .001).
• They found that patients woke up 44 minutes (95% CI, 44-45 minutes; P < .001) earlier than their habitual wake-up time at home.
• One thousand, three hundred forty-four patients (70.4%) reported having been awakened by external causes, which in 718 (35.8%) concerned hospital staff.
• The present data indicated that all aspects of sleep quality measured using PROMIS questions were rated worse during hospitalization than at home.
• The noise of other patients, medical devices, pain, and toilet visits were the most reported sleep-disturbing factors.