Format

Send to

Choose Destination
J Clin Sleep Med. 2017 Feb 15;13(2):301-306. doi: 10.5664/jcsm.6468.

Awakenings? Patient and Hospital Staff Perceptions of Nighttime Disruptions and Their Effect on Patient Sleep.

Author information

1
University of Chicago Pritzker School of Medicine, Chicago, IL.
2
Department of Medicine, University of Chicago, Chicago, IL.
3
CareMore Health Plan.
4
The University of Chicago Medicine, Chicago, IL.
5
Section of Pulmonary and Critical Care, Columbia St. Mary's Hospital, Milwaukee, WI.

Abstract

STUDY OBJECTIVES:

Although important to recovery, sleeping in the hospital is difficult because of disruptions. Understanding how patients, hospital physicians, and nurses perceive sleep disruptions and identifying which disruptions are associated with objective sleep loss can help target improvement initiatives.

METHODS:

Patients and hospital staff completed the Potential Hospital Sleep Disruptions and Noises Questionnaire (PHSDNQ). Cutoff points were defined based on means, and responses were dichotomized. Perceived percent disrupted for each item was calculated, and responses were compared across groups using chi-square tests. Objective sleep time of patients was measured using wrist actigraphy. The association between patient-reported disruptions and objective sleep time was assessed using a multivariable linear regression model controlling for subject random effects.

RESULTS:

Twenty-eight physicians (78%), 37 nurses (88%), and 166 of their patients completed the PHSDNQ. Patients, physicians, and nurses agreed that pain, vital signs and tests were the top three disrupters to patient sleep. Significant differences among the groups' perceptions existed for alarms [24% (patients) vs. 46% (physicians) vs. 27% (nurses), p < 0.040], room temperature (15% vs. 0% vs. 5%, p < 0.031) and anxiety (18% vs. 21% vs. 38%, p < 0.031). Using survey and actigraphy data from 645 nights and 379 patients, the presence of pain was the only disruption associated with lower objective sleep duration (minutes) [-38.1 (95% confidence interval -63.2, -12.9) p < 0.003].

CONCLUSION:

Hospital staff and patients agreed that pain, vital signs and tests were top sleep disrupters. However, pain was associated with the greatest objective sleep loss, highlighting the need for proactive screening and management of patient pain to improve sleep in hospitals.

KEYWORDS:

disruptions; noise; pain; quality improvement; sleep

PMID:
27923432
PMCID:
PMC5263086
DOI:
10.5664/jcsm.6468
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for American Academy of Sleep Medicine Icon for PubMed Central
Loading ...
Support Center