Sleep Quality in an Acute Inpatient Rehabilitation Setting: The Importance of Prior Sleep Disorders

Abstract

<h3>Research Objectives</h3> To assess whether demographic and clinical factors might impact sleep quality during inpatient stay in a rehabilitation setting. <h3>Design</h3> Patients were assessed for their sleep quality at admission and discharge. Demographic and clinical data were collected (i.e., age, Body Mass Index-BMI, gender, race, cause of hospitalization, pre-hospital setting and prior diagnosis of sleep disorders). The levels of anxiety and depression were also assessed. <h3>Setting</h3> acute inpatient rehabilitation unit of Casa Colina Hospital and Centers for Healthcare (Pomona, California). <h3>Participants</h3> Thirty five patients participated to this study (age=61±16 years old; BMI=30±7kg/m2; 18 females, 18 Caucasians). The average length of hospitalization was 18±8 days. Cause of hospitalization included stroke (20%), spinal cord injury (28%), orthopedic (28%) and other (23%). In this sample, 23% had prior sleep disorders (mostly, sleep apnea) and 60% came from an acute care unit. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> the Pittsburgh Sleep Quality Index (PSQI), the Beck Anxiety Inventory (BAI) and the Patient Health Questionnaire-9 (PHQ-9). <h3>Results</h3> ANOVAs with repeated measures were performed on the outcome measure (PSQI) controlling for BMI and age. Among the demographic and clinical variables considered, prior sleep disorders had a strong effect on changes in PSQI total scores [F(1,33)= 14.74, p < .001]. The PSQI decreased only in patients with prior diagnosis of sleep disorders [F(1,33)= 5.86, p < .05]. The pre-hospital setting trended toward significance for the group without sleep disorders [F(1,33)= 3.55, p=.07]. Changes in BAI [F(1,33)= 5.02, p < .05] and PHQ-9 [F(1,33)= 5.47, p < .05] total scores were related to changes in PSQI. Finally, our dataset did not reveal an effect of race or gender. <h3>Conclusions</h3> Sleep quality of patients with sleep disorders can deteriorate over inpatient stay and should be addressed in order to optimize recovery during rehabilitation. <h3>Author(s) Disclosures</h3> None.