Abstract
BackgroundSleep quality in hospitalized Canadian General Internal Medicine patients is not well characterized. Our goals were to characterize hospital sleep quality in this population and identify potentially modifiable barriers to good sleep.MethodsGIM inpatients at a quaternary centre in Edmonton, Canada completed a survey, including the Verran-Snyder Halpern (VSH) questionnaire, to characterize the previous night’s sleep within 48 hours prior to discharge. A chart review was also completed to assess comorbidities, discharge diagnoses, and pharmaceutical sleep aid use.ResultsPatients reported significantly worse nighttime sleep duration in hospital compared with home (mean 5.5 versus 7.0 hours per night, p < 0.0001). Sleep quality was poor, as measured by the VSH disturbance (mean 371), effectiveness (190), and supplementation (115) subscales. Variables independently associated with poorer sleep duration in multivariable regression include prior diagnosis of sleep disorder and multi-patient occupancy rooms. Age, sex, admitting diagnosis, length of stay, frequency of vital checks, and use of sleep pharmaceuticals during the index hospitalization were not associated with sleep duration. The most frequently reported reasons for poor sleep included noise (59%), nursing interruptions (30%), uncomfortable beds (18%), bright lights (16%), unfamiliar surroundings (14%), and pain (9%).ConclusionsSleep quality for GIM inpatients is significantly worse in hospital than at home. There is a need to test non-pharmacologic interventions to address the most frequently identified factors causing poor sleep hygiene for GIM inpatients.
Highlights
Insomnia, the subjective disruption of the quantity or quality of sleep, affects 4–38% of North Americans and 6–70% people worldwide [1]
Patients reported significantly worse nighttime sleep duration in hospital compared with home
Variables independently associated with poorer sleep duration in multivariable regression include prior diagnosis of sleep disorder and multi-patient occupancy rooms
Summary
The subjective disruption of the quantity or quality of sleep, affects 4–38% of North Americans and 6–70% people worldwide [1]. Hospitalization can further disrupt sleep due to active medical problems, medications, loss of the normal sleep-wake cycle, decreased daytime activity, and noise [3,4,5]. Due to their medical complexity, general internal medicine (GIM) patients are high risk for both insomnia and complications of insomnia, such as delirium and falls [2,6]. Sleep quality in hospitalized Canadian General Internal Medicine patients is not well characterized. Our goals were to characterize hospital sleep quality in this population and identify potentially modifiable barriers to good sleep
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