Abstract
Sleep disturbances, including insomnia in particular, are common concerns among hospitalized patients and can have a significant impact on duration of hospital admissions, recovery time, and rehabilitation efforts. As such, the following chapter provides practical tips for preventing, assessing, and treating sleep disturbances among inpatients in order to reduce healthcare costs and maximize patient outcomes. Specifically, healthcare providers can reduce sleep disturbances by minimizing noise and light in the inpatient environment, standardizing the timing of vital sign assessments to reduce sleep fragmentation, and educating patients about healthy sleep habits. Moreover, assessing common causes and consequences of sleep disturbance, such as pain and depression, can help to identify patients at risk for developing disturbed sleep and provide additional targets for intervention. Increased awareness and education about the causes, consequences, and approaches to treating sleep issues among inpatient medical and rehabilitation patients is key to improving patient outcomes.
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References
Freedman NS, Kotzer N, Schwab RJ. Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit. Am J Respir Crit Care Med. 1999;159:1155–62.
Rotondi AJ, Chelluri L, Sirio C, Mendelsohn A, Schulz R, Belle S, Im K, Donahoe M, Pinsky MR. Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med. 2002;30:746–52.
Freedman NS, Gazendam J, Levan L, Pack AI, Schwab RJ. Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med. 2001;163:451–7.
Hilton BA. Quantity and quality of patients’ sleep and sleep-disturbing factors in a respiratory intensive care unit. J Adv Nurs. 1976;1:453–68.
Rosenberg-Adamsen S, Skarbye M, Wildschiodtz G, Kehlet H, Rosenberg J. Sleep after laparoscopic cholecystectomy. Br J Anaesth. 1996;77:572–5.
Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington: American Psychiatric Publishing; 2013.
Vico-Romero J, Cabre-Roure M, Monteis-Cahis R, Palomera-Faneges E, Serra-Prat M. Prevalence of sleep disorders and associated factors in inpatient. Enferm Clin. 2014;24:276–82.
Redeker NS. Sleep in acute care settings: an integrative review. J Nurs Scholarsh. 2000;32:31–8.
Missildine K. Sleep and the sleep environment of older adults in acute care settings. J Gerontol Nurs. 2008;34:15–21.
Friese RS, Diaz-Arrastia R, McBride D, Frankel H, Gentilello LM. Quantity and quality of sleep in the surgical intensive care unit: are our patients sleeping? J Trauma. 2007;63:1210–4.
Yoder JC, Staisiunas PG, Meltzer DO, Knutson KL, Arora VM. Noise and sleep among adult medical inpatients: far from a quiet night. Arch Intern Med. 2012;172:68–70.
Patel M, Chipman J, Carlin BW, Shade D. Sleep in the intensive care unit setting. Crit Care Nurs Q. 2008;31:309–18.
Gabor JY, Cooper AB, Crombach SA, Lee B, Kadikar N, Bettger HE, Hanly PJ. Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects. Am J Respir Crit Care Med. 2003;167:708–15.
Pilowsky I, Crettenden I, Townley M. Sleep disturbance in pain clinic patients. Pain. 1985;23:27–33.
Walder B, Francioli D, Meyer JJ, Lancon M, Romand JA. Effects of guidelines implementation in a surgical intensive care unit to control nighttime light and noise levels. Crit Care Med. 2000;28:2242–7.
Makley MJ, English JB, Drubach DA, Kreuz AJ, Celnik PA, Tarwater PM. Prevalence of sleep disturbance in closed head injury patients in a rehabilitation unit. Neurorehabil Neural Repair. 2008;22:341–7.
Ponsford JL, Ziino C, Parcell DL, Shekleton JA, Roper M, Redman JR, Phipps-Nelson J, Rajaratnam SM. Fatigue and sleep disturbance following traumatic brain injury—their nature, causes, and potential treatments. J Head Trauma Rehabil. 2012;27:224–33.
Benca RM, Quintas J. Sleep and host defenses: a review. Sleep. 1997;20:1027–37.
Weinhouse GL, Schwab RJ. Sleep in the critically ill patient. Sleep. 2006;29:707–16.
Friese RS. Sleep and recovery from critical illness and injury: a review of theory, current practice, and future directions. Crit Care Med. 2008;36:697–705.
Irwin MR, Wang M, Campomayor CO, Collado-Hidalgo A, Cole S. Sleep deprivation and activation of morning levels of cellular and genomic markers of inflammation. Arch Intern Med. 2006;166:1756–62.
Kamdar BB, Needham DM, Collop NA. Sleep deprivation in critical illness: its role in physical and psychological recovery. J Intensive Care Med. 2012;27:97–111.
Mullington JM, Haack M, Toth M, Serrador JM, Meier-Ewert HK. Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. Prog Cardiovasc Dis. 2009;51:294–302.
Valente M, Placidi F, Oliveira AJ, Bigagli A, Morghen I, Proietti R, Gigli GL. Sleep organization pattern as a prognostic marker at the subacute stage of post-traumatic coma. Clin Neurophysiol. 2002;113:1798–805.
Thomas KP, Salas RE, Gamaldo C, Chik Y, Huffman L, Rasquinha R, Hoesch RE. Sleep rounds: a multidisciplinary approach to optimize sleep quality and satisfaction in hospitalized patients. J Hosp Med. 2012;7:508–12.
Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004;8:119–32.
Wittig RM, Zorick FJ, Blumer D, Heilbronn M, Roth T. Disturbed sleep in patients complaining of chronic pain. J Nerv Ment Dis. 1982;170:429–31.
Morin CM, LeBlanc M, Daley M, Gregoire JP, Merette C. Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med. 2006;7:123–30.
Smith MT, Perlis ML, Carmody TP, Smith MS, Giles DE. Presleep cognitions in patients with insomnia secondary to chronic pain. J Behav Med. 2001;24:93–114.
Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep. 2007;30:213–8.
Doufas AG, Panagiotou OA, Ioannidis JP. Concordance of sleep and pain outcomes of diverse interventions: an umbrella review. PLoS One. 2012;7, e40891.
Wilson KG, Eriksson MY, D’Eon JL, Mikail SF, Emery PC. Major depression and insomnia in chronic pain. Clin J Pain. 2002;18:77–83.
Sunderajan P, Gaynes BN, Wisniewski SR, Miyahara S, Fava M, Akingbala F, DeVeaugh-Geiss J, Rush AJ, Trivedi MH. Insomnia in patients with depression: a STAR*D report. CNS Spectr. 2010;15:394–404.
Vollrath M, Wicki W, Angst J. The Zurich study. VIII. Insomnia: association with depression, anxiety, somatic syndromes, and course of insomnia. Eur Arch Psychiatry Neurol Sci. 1989;239:113–24.
Hohagen F, Rink K, Kappler C, Schramm E, Riemann D, Weyerer S, Berger M. Prevalence and treatment of insomnia in general practice. A longitudinal study. Eur Arch Psychiatry Clin Neurosci. 1993;242:329–36.
Schramm E, Hohagen F, Kappler C, Grasshoff U, Berger M. Mental comorbidity of chronic insomnia in general practice attenders using DSM-III-R. Acta Psychiatr Scand. 1995;91:10–7.
Manber R, Bernert RA, Suh S, Nowakowski S, Siebern AT, Ong JC. CBT for insomnia in patients with high and low depressive symptom severity: adherence and clinical outcomes. J Clin Sleep Med. 2011;7:645–52.
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Buenaver, L.F., Richards, J., Gathecha, E. (2017). Sleep Issues in Medical Rehabilitation. In: Budd, M., Hough, S., Wegener, S., Stiers, W. (eds) Practical Psychology in Medical Rehabilitation. Springer, Cham. https://doi.org/10.1007/978-3-319-34034-0_32
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DOI: https://doi.org/10.1007/978-3-319-34034-0_32
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