Non-pharmacologic interventions to improve sleep of medicine inpatients: a controlled study

Abstract

Background: Sleep quality in hospitalized medicine patients is poor, with environmental factors among the most frequently cited reasons. Objective: We tested the efficacy of a non-pharmacologic intervention on the sleep quality of medicine inpatients. Design/Methods: A controlled study to evaluate our non-pharmacologic multidisciplinary ‘TUCK-in’ protocol (which includes timed lights-off periods, minimizing night-time noise, distribution of earplugs at bedtime, cued toileting before bedtime, and identification and reduction of modifiable interruptions) was deployed on two of five identical medicine wards. Randomization was at the level of the ward. The main outcome measure was self-reported duration of night-time sleep within 48 hours prior to discharge. Additional outcome measures included the Verran–Snyder-Halpern (VSH) Sleep Score and inpatient sleep pharmaceutical use. Results: Self-reported duration of night-time sleep (median 5.0 vs. 5.0 hours, p = 0.29) and daytime sleep (1.0 versus 0.5 hours, p = 0.43) did not differ between the 40 intervention patients and the 41 control patients (p = 0.13 on multivariate analysis). Cumulative VSH sleep disturbance (median 420 versus 359, p = 0.19), efficacy (median 169 versus 192, p = 0.29), or supplementation (median 97 versus 100, p = 0.51) scales were also not different between study arms. Conclusions: Although staff reported the protocol to be achievable and worthwhile, there were no significant differences in any of the outcomes between intervention and control patients.​

Keywords

• Sleep quality
• inpatient sleep
• non-pharmacologic interventions
• sleep hygiene
• factors affecting sleep