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Poor sleep in the hospital: Contributing factors and interventions

Dennis Auckley, MD
Section Editor
Ruth Benca, MD, PhD
Deputy Editor
April F Eichler, MD, MPH


The need for sleep has long been assumed to be important for recovery from injury and sickness, and there is an emerging understanding of the restorative role of sleep in health and disease. Unfortunately, the hospital environment is often poorly conducive to sleep [1,2]. Pain, anxiety, medication effects, medical interventions, and the acute illness itself all contribute to decreased quality and quantity of sleep in hospitalized patients. As a result, issues related to sleep and sleep disorders are important to inpatient care.

This review will discuss the evaluation, consequences, and management of sleep disturbances in hospitalized adult patients. The evaluation and management of obstructive sleep apnea and other sleep disorders in the inpatient setting is reviewed separately. (See "Sleep disorders in hospitalized adults: Evaluation and management".)


Hospitalized patients experience fragmented and poor quality sleep and are at risk for marked circadian rhythm disturbances. All of these changes become more pronounced with worsening severity of illness as well as in the immediate postoperative period. In some cases, sleep impairments persist well beyond the acute illness [3-5].

Poor sleep quality — Patients regularly report poor quality sleep during hospitalization across a range of inpatient settings, perhaps most notably in the intensive care unit (ICU) [6-9]. Impaired sleep quality has been cited by ICU patients as one of the main stressors during admission [10,11]

Small studies using inpatient polysomnography (PSG) have verified that ICU patients experience significant alterations in their sleep architecture, to an extent that traditional rules for scoring sleep stages may not be applicable in some critically ill patients [12-15].


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Literature review current through: Sep 2016. | This topic last updated: May 30, 2016.
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