Health Care

6 Practical Ways to Improve Inpatient Sleep

11:01:00 PM Devender Sisodia 0 Comments

The quality of sleep greatly affects the health and recovery of inpatients. Unfortunately, it is almost impossible to get a good night's sleep with all the activities happening around the hospital. As a result, inpatients suffer from sleep loss.

This leads to an increase in blood pressure, hyperglycemia, pain perception, and hospital-acquired infections. Further, lack of sleep contributes to falls, reduced ability to participate in physical therapy and care planning, and depression.


Clearly, there is a need to focus on the improvement of inpatient sleep quality. But instead of prescribing more medications to counter the negative effects of sleep loss, hospitalists can achieve the same goal through practical methods as outlined below:

1. Fix the lighting. In the morning, encourage inpatients to raise the shades and let plenty of sunshine in. Adequate exposure to daylight promotes a healthy circadian rhythm. Conversely, in the evening, advise them to keep the room dark. Close the curtains, use an eye mask, and stay clear of the TV, computer, or smartphone.

2. Establish a quiet time. Make an effort to lower noise levels around the hospital between 10 PM and 6 AM. While the activities outside an inpatient's room are unlikely to stop, the noise they generate can be regulated at a maximum of 30 decibels, which is the level of quiet conversation.

3. Limit night-time procedures. Instead of waking up stable inpatients to take their vital signs at 12 midnight, consider getting them at 10 PM. You can also reschedule 4 AM blood draws at 6 AM and avoid blood transfusions at night. Other interventions include not administering diuretics after 4 PM, not running IVF overnight, changing sleep-disrupting medications, and not placing IV catheters in the antecubital fossae.

Additionally, make flexible drug orders. Instead of making a q-4 or q-6 order, write BID, TID, or QID. Look at it this way: a QID order promotes better sleep for inpatients as the drug can be administered any four times in the day without having to wake the patients as opposed to having an exact hour where the doses must be administered.

4. Manage pain. Uncontrolled pain is one of the biggest factors leading to loss of sleep. To make it worse, an inpatient without enough sleep is more sensitive to pain. It is a vicious cycle. To promote better sleep, pain must be managed adequately. Hospitalists must screen for pain at night and see which inpatients need help in dealing with their pain or other symptoms.

5. Teach inpatients to relax before going to bed.Identify activities that the patients can do to facilitate relaxation. These include meditation, listening to music, or getting a massage. Deep breathing exercises may also be instructed. It is a great way to ease tension and sleep better. However, if the inpatient still cannot fall asleep, a short walk or doing other light activities like reading or solving crossword puzzles may help a bit.

6. Provide guidance on healthy daytime activities. What a person does in the morning has an impact on sleep. Provide inpatient education and teach them activities that will promote better sleep. For instance, advise them to take naps earlier in the day, or tell them to avoid caffeine after noon and to finish eating dinner three hours before bedtime. Encourage them to exercise, too. Inpatients can walk around the hospital floor or do simple exercises in their bed or chair.

These are only a few ideas to improve the quality of sleep of inpatients. They are simple enough but when implemented consistently and thoughtfully, these strategies can make a big impact in addressing sleep loss and preventing its many adverse effects.

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