Hospitalized patients often experience sleep deprivation due to poorly designed hospital environments. Patients face challenges such as loud noises, poor control of ambient light, and frequent nighttime disruptions, all of which contribute to inadequate rest. This sleep deprivation has significant physiologic consequences, including cardiovascular, immune, and cognitive dysfunction. Poor sleep quality is associated with adverse hospital outcomes, including increased readmission rates, higher hospital-acquired infection rates, and decreased patient satisfaction. To improve sleep quality, hospitals should provide patients with earplugs and eye masks, limit noise and disruptions, and align lighting with natural sleep cycles. Physicians often endure significant sleep deprivation, beginning in their training and continuing throughout their careers, that negatively affects their well-being and patient care. It also can contribute to burnout. Addressing sleep deprivation for physicians is essential for maintaining their health and improving quality of care and requires policy and culture changes.

Case 4. HK is a 72-year-old woman who was recently transferred to the medical floor from the intensive care unit where she received treatment for sepsis due to pneumonia. Although her vital signs are stable and her oxygen requirements are improving with antibiotic therapy, her mental status has worsened. She appears to have developed symptoms of delirium. The nurse reports that HK slept for much of the previous afternoon but was awake and calling out for most of the night. He asks you to consider ordering something to help HK sleep.