Sharla Keough, University of Pennsylvania School of Nursing

We all understand how important a good night’s sleep is for our health. We try to incorporate practices into our daily routine in order to help us achieve a high-quality rest to prepare for the next day’s challenges. There is no doubt that restful sleep is a self-care practice, but this seems to be forgotten as a person is admitted into the hospital. Why is it that when a person becomes a patient, all regards for their tranquil night seems to be thrown out the window?

 The activity of sleeping and its effects on the body are not well understood by scientists. However, there are many benefits to sleep that have been solidified by many research studies. These benefits include macromolecule biosynthesis, prophylactic cellular maintenance, removal of toxic substances, reduced stress levels, and decreased inflammation (Vyazovskiy, 2015). These processes are important for any individual, which is why the recommended amount of sleep of seven to nine hours a night should be obtained to receive the full benefits. In our society, there are constant advertisements about improving one’s sleep health, whether that be through a new mattress, aromatherapy, weighted blankets, or some type of natural supplement. As a group, we are consistently trying to improve our sleep health knowing the benefits of this practice. However, in the hospital there is not a clear effort to encourage high-quality sleep for patients. A hospital room can be a sterile and unfamiliar place for patients, which can prevent them from becoming comfortable enough to fall into a deep sleep. Anyone who has to be admitted for a hospital stay will naturally be anxious and fearful, further impeding deep sleep. Furthermore, there are constant flashes of light, loud beeping noises, and constant conversations with healthcare providers in the hallway. If the patient has a roommate, this can be a further stressor to prevent sleep if that patient needs more attention. In addition to these environmental factors, the patient may be repeatedly awoken throughout the night for vital sign values and blood draws. These disturbances for patients can lead to adverse effects, such as alterations in glucose metabolism and decreased cellular immunity (Growdon & Inouye, 2018). These barriers to sleep are especially upsetting considering that this population requires high-quality sleep to regain strength and be discharged.

 Knowing the challenges that patients face in their quest for a good night’s sleep is daunting, but studies have shown that providing interventions for this population is essential in order to improve quality of sleep. In one study, it was found that antepartum patients who received a hospital kit with sleep-improving objects had decreased sleep disturbances and fewer symptoms compared with patients who did not receive this kit (Lee & Gay, 2017). It is important that healthcare workers recognize the hurdles patients face during the nighttime hours and provide interventions that help patients rest more easily. These interventions can include decreased lighting at night, staff training to minimize disruptions, providing ear plugs and sleeping masks, and educating patients about the benefits of sleep (Growdon & Inouye, 2018). Certainly, some medical procedures cannot wait until the morning and must be performed at night, but all non-essential procedures should take place in the morning.

 The first step to combatting interrupted sleep in the hospital is to recognize that it is a prevalent issue and that measures can be taken to decrease these disruptions. If patients are provided with resources to encourage good sleep hygiene, then they will be more aware of the benefits of a good night’s sleep. Sleep is a self-care practice that is overlooked when a person becomes a patient in a hospital, but it is a human need that must be protected in order for patients to heal and achieve an optimum level of health.

References

Growdon, M., Inouye, S. (2018). Minimizing sleep disruption for hospitalized patients: A wake-up call. Journal of the American Medical Association, 178(9): 1208-1209. doi: 10.1001/jamainternmed.2018.2679

Lee, K., Gay, C. (2017). Improving sleep for hospitalized antepartum patients: A non-randomized controlled pilot study. Journal of Clinical Sleep Medicine, 13(12): 1445–1453. Doi: 10.5664/jcsm.6846

Vyazovskiy, V. (2015). Sleep, recovery, and metaregulation: Explaining the benefits of sleep. Nature and Science of Sleep, (7): 171-184. Doi: 10.2147/NSS.S54036