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Sleep hygiene may improve sleep for older, hospitalized patients

Thursday, May 10 2007 | Comments

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What's This? Consistently applying sleep hygiene protocol may significantly increase sleep hours over time for older patients in an acute care hospital setting, new data show.

Rita LaReau, geriatric clinical nurse specialist at Bronson Methodist Hospital in Kalamazoo, Mich., and colleagues randomized 59 patients aged 65 years or older to either a control group or a treatment group. Patients were randomized at the time of admission into either the hospital's cardiovascular unit or adult medical unit.

In the experimental group, nurses were aware of the patient's usual bedtime, offered personal hygiene assistance prior to bed, provided a 5-minute backrub, straightened bed linens, avoided talking at bedside and using overhead intercoms, and adjusted room temperature, light levels, and televisions or radios according to patient preferences.

Both patient groups used the Richards-Campbell Sleep Questionnaire to rate sleep quality. Although no significant differences were seen between the control group and the experimental group in terms of the number of sleep hours or awakenings, a separate analysis of only the experimental group found a significant increase in sleep hours from the patients' first night-time sleep episode to the patients' last night-time sleep episode during the study period.

The median number of sleep hours for patients in the experimental group increased from 6 hours at the first sleep episode to 7.5 hours at the last sleep episode (P=.0469). However, there was no significant difference in the number of awakenings from first to last sleep episode.

LaReau told VerusMed that a larger study should to be done to further explore the effect of sleep hygiene in older adults in acute care hospitals.

"Most of the studies are in the nursing home setting," she said, noting that sleep is also important for hospitalized patients because they are very frail when they are admitted. By not getting enough sleep, they can develop delirium and become even weaker, which puts into action a "cascade of negative outcomes."

LaReau noted that this study has been submitted for publication as a feasibility trial in the journal Geriatric Nursing. (Poster B73.)

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