Rationale and Comments
Inadequate sleep in hospitalized patients has been associated with poor outcomes, including high blood pressure, hyperglycemia, immune dysfunction, and delirium. Environmental factors (e.g., noise, light disruptions), care-related factors (e.g., blood draws, vital signs), and patient factors (e.g., illness, pain) all contribute to sleep disruption. It is generally recommended that nonpharmacologic interventions be the first line of prevention. Although data are limited, multifaceted interventions targeting modifiable factors including nighttime interventions to decrease noise and light, group care activities, and minimizing unnecessary patient contact (i.e., decreasing vital sign frequency, blood draws) may improve sleep quality and duration. Nonpharmacologic sleep aids (e.g., earplugs, eye masks, relaxation techniques) can be easily adopted and may provide some benefit.
Sponsoring Organizations
- Society of Hospital Medicine – Adult Hospital Medicine
Sources
Disciplines
- Psychiatric and psychologic
References
- Hu RF, Jiang XY, Chen J, et al. Non-pharmacological interventions for sleep promotion in the intensive care unit. Cochrane Database Syst Rev. 2015;2015(10):CD008808.
- Tamrat R, Huynh-Le MP, Goyal M. Non-pharmacologic interventions to improve the sleep of hospitalized patients: a systematic review. J Gen Intern Med. 2014;29(5):788-795.
- Kamdar BB, King LM, Collop NA, et al. The effect of a quality improvement intervention on perceived sleep quality and cognition in a medical ICU. Crit Care Med. 2013;41(3):800-809.
- Kamdar BB, Needham DM, Collop NA. Sleep deprivation in critical illness: its role in physical and psychological recovery. J Intensive Care Med. 2012;27(2):97-111.
- Stewart NH, Arora VM. Sleep in hospitalized older adults. Sleep Med Clin. 2018;13(1):127-135.
- Miller MA, Renn BN, Chu F, et al. Sleepless in the hospital: a systematic review of non-pharmacological sleep interventions. Gen Hosp Psychiatry. 2019;59:58-66.