Awakenings? Patient and Hospital Staff Perceptions of Nighttime Disruptions and Their Effect on Patient Sleep
Open accessAbstract
Study objectives Although important to recovery, sleeping in the hospital is difficult because of disruptions. Understanding how patients, hospital physicians, and nurses perceive sleep disruptions and identifying which disruptions are associated with objective sleep loss can help target improvement initiatives.Methods Patients and hospital staff completed the Potential Hospital Sleep Disruptions and Noises Questionnaire (PHSDNQ). Cutoff points were defined based on means, and responses were dichotomized. Perceived percent disrupted for each item was calculated, and responses were compared across groups using chi-square tests. Objective sleep time of patients was measured using wrist actigraphy. The association between patient-reported disruptions and objective sleep time was assessed using a multivariable linear regression model controlling for subject random effects.Results Twenty-eight physicians (78%), 37 nurses (88%), and 166 of their patients completed the PHSDNQ. Patients, physicians, and nurses agreed that pain, vital signs and tests were the top three disrupters to patient sleep. Significant differences among the groups' perceptions existed for alarms [24% (patients) vs. 46% (physicians) vs. 27% (nurses), p < 0.040], room temperature (15% vs. 0% vs. 5%, p < 0.031) and anxiety (18% vs. 21% vs. 38%, p < 0.031). Using survey and actigraphy data from 645 nights and 379 patients, the presence of pain was the only disruption associated with lower objective sleep duration (minutes) [-38.1 (95% confidence interval -63.2, -12.9) p < 0.003].Conclusion Hospital staff and patients agreed that pain, vital signs and tests were top sleep disrupters. However, pain was associated with the greatest objective sleep loss, highlighting the need for proactive screening and management of patient pain to improve sleep in hospitals.
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Facilitating Sleep in the Hospital
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- Authors
- Grossman, M. N., Anderson, S. L., Worku, A., Marsack, W., Desai, N., Tuvilleja, A., Ramos, J., Francisco, M. A., Lafond, C., Balachandran, J. S., Mokhlesi, B., Farnan, J. M., Meltzer, D. O., & Arora, V. M.
- Affiliations
- University of Chicago (US)
- Columbia St. Mary's Hospital (US)
- ORCID
- Venue
- Journal of Clinical Sleep Medicine
- Published
- 2017-02-15
- Volume
- 13
- Issue
- 2
- Pages
- 301-306
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- PMC
- PMC5263086
- OpenAlex
- W2588455485
- Cited by
- 73
- References
- 21
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 8 · 2023: 9 · 2022: 12 · 2021: 7 · 2020: 8 · 2019: 5 · 2018: 4 · 2017: 2
- FWCI
- 6.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Sleep Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (T35AG029795)
- National Heart, Lung, and Blood Institute (R25HL116372)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Keywords
- patient sleep, pain, nurses' perceptions, physician perceptions, room temperature, anxiety, hospital noise
- MeSH terms
- Aged, Attitude of Health Personnel, Attitude to Health, Female, Humans, Inpatients, Sleep Initiation and Maintenance Disorders, Male, Medical Staff, Hospital, Middle Aged, Nursing Staff, Hospital, Personnel, Hospital, Surveys and Questionnaires, Sleep, Time Factors, Actigraphy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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