234 - The Hospital Is an Enemy of Sleep
Massimo Sandal, May 15, 2024
https://www.medscape.com/viewarticle/hospital-enemy-sleep-2024a100098m?ecd=WNL_trdalrt_pos2_ous_240520_etid6530089&uac=305958HN&impID=6530089Sleep in the hospital is poor. A meta-analysis from 2022 that examined 203 studies showed that the average total sleep time for hospitalized patients varies significantly between age groups. Children and adolescents sleep an average of about 7.8 hours per night, while adults and older adults manage to sleep only 5.6 and 5.8 hours, respectively. A substantial majority of studies, approximately 76% of those examined, reported sleep duration below the average considered healthy. Almost half of the studies indicated that adults slept less than 6 hours per night: A threshold commonly associated with adverse health outcomes. Furthermore, patients frequently experience numerous nocturnal awakenings (up to 42 times per night) and prolonged awakenings after sleep onset of over 105 minutes.
Pediatric patients, however, are a separate case. According to the meta-analysis, sleep efficiency in children overall remains comparable to that in healthy populations. But sleep quality in hospitalized children is deficient, and hospitalization affects children of various ages differently. Several studies have reported that bright light during the day improves the quality of nighttime sleep, and patients admitted near windows, and thus exposed to a natural light rhythm, tend to sleep better.
"Not sleeping disturbs recovery mechanisms from illness. The circadian rhythms of production of numerous hormones are altered, including insulin, nighttime blood pressure often increases with increased cardiac workload, oxidative stress increases, and a general inflammatory state is observed. So obviously, the patient struggles to recover, and moreover, in a vicious cycle, stress, anxiety, and concern increase. Consequently, this will only lead to further worsening of insomnia," said Casoni
...............................................Sl
eeping in hospitals.. What a nightmare …..
Here is a summary from the article of the disturbances and frequency .......
"Sleep disturbance is one of the major risk factors for delirium," said Casoni. "An elderly patient, perhaps delirious and disoriented, could get up, fall, and suffer, for example, a hip fracture.
Noise: The Main Problem One of these studies [sound peaks] attributed
20% of sleep awakenings to noise level peaks, while another indicated that
environmental noise caused 11.5% of interruptions and 17% of awakenings. The average noise level in hospitals could also play a crucial role.
- Nursing call bells/signals
- Noises, calling, crying, screaming from other patients
- Nursing checks every 2 hours, periodic vitals
- Shift Change and handover by staff at midnight and early morning
- Ambulance sirens or reversing signals