Abstract
Introduction:
Sleep is an essential requirement for good health. The hospital environment is often not compatible with adequate, restorative sleep. Disruption is multifactorial and affecting parameters can be environmental, physical, or psychological.
Aims:
To observe the difference in sleep quality in patients on medical wards compared with their baseline and highlight areas where sleep quality can be improved.
Methods:
This observational study analysed patients on four medical wards at Chelsea and Westminster Hospital. Inclusion criteria: Patients with good cognition who had been in hospital for over a week. We used a modified Jenkins sleep questionnaire in which patients’ sleep before and during their hospital stay was compared, assigning a score to each. Questions assessed how often in a week patients had difficulty sleeping, waking up too often or early, and feeling exhausted. The higher the score the worse the sleep quality. Patients were also invited to report factors contributing to sleep disturbances and make suggestions.
Results:
Overall, sleep quality was reduced in hospital. Across all patients, the cumulative modified Jenkins score increased by 70% from 144 to 245 (n =25). The mean sleep satisfaction score was 6.08/10, the range was 10, and the median was 7. The median score amongst both side rooms (n=10/25) and open bay patients (n=15/25) was equal (6.6). Amongst the qualitative data, common themes were identified: noise, light and overnight observations. Of the two patients who used eye masks/sleeping aids, both were very satisfied with their sleep. Similar findings are echoed in existing literature.
Conclusion:
Hospital admission is associated with worse sleep. The introduction of eye-masks and earplugs more routinely may improve sleep quality and prevent overuse of hypnotics, which can lead to potential complications. Additionally, optimising frequency of overnight observations, guided by patients’ National Early Warning Score may reduce interruptions amongst medically fit patients overnight.