The Science Of Sleep: Hospital Edition

Sleep is essential to overall health and recovery. However, it is a common complaint that it can be challenging to get a good night's rest in a hospital due to various factors such as noise, light, medication timing, and illness. Hospitals are beginning to recognize the importance of uninterrupted sleep for patients and are implementing changes to improve nighttime routines. Additionally, there are steps patients can take to enhance their sleep quality during their stay, such as bringing familiar items, maintaining their sleep schedule, and engaging in relaxation techniques. In certain cases, pharmacological sleep aids may be prescribed, but these come with risks such as delirium and falls. For surgical procedures, general anesthesia is administered to induce a deep sleep, rendering the patient unaware of their surroundings and free from pain.

Hospitals use general anaesthesia to put patients to sleep for surgery

When it comes to surgical procedures, hospitals use general anaesthesia to put patients to sleep. General anaesthesia involves administering certain medications that induce a deep sleep, ensuring patients remain unconscious and free from pain during the operation. Typically, an anaesthesiologist, a specialised doctor, or a certified registered nurse anaesthetist is responsible for providing anaesthesia.

Anaesthesia often requires the use of multiple medications, which can be administered intravenously or by inhalation. In some cases, patients may be asked to breathe in a special gas through a mask. Once the patient is asleep, a tube may be inserted into their windpipe (trachea) to facilitate breathing and protect their lungs.

During the procedure, the patient's vital signs, including blood pressure, pulse, and breathing, are closely monitored. The anaesthesiologist can adjust the depth of anaesthesia as needed throughout the surgery. After the surgery, patients typically wake up in a recovery room, feeling groggy and disoriented with possible side effects like nausea and vomiting. However, these side effects are temporary and carefully monitored by medical staff.

To ensure the safety of patients, a complete medical history is taken before administering general anaesthesia. This includes information about allergies, health conditions, medications, and previous experiences with anaesthesia. Patients may be advised to stop taking certain medications, such as blood thinners, several days to a week before the surgery. Additionally, it is standard procedure to refrain from consuming any food or drinks after midnight on the day before the surgery.

General anaesthesia is generally considered safe, especially with modern equipment, medicines, and safety protocols in place. Most individuals recover fully without experiencing any complications. However, certain factors, such as excessive alcohol consumption or the use of sedatives, opioids, or illicit drugs, may increase the risk of complications during anaesthesia.

Patients can request pharmacological sleep aids, but these carry risks

Sleep is essential to overall health and recovery. However, it is a common complaint that it can be difficult to get a good night's sleep in a hospital. Hospital routines, medication timing, blood draws, blood pressure testing, and the hospital environment, such as noise and light, can all contribute to sleep disturbances for patients.

While hospitals are actively trying to improve patient sleep by rescheduling activities and reducing interruptions, patients can also request pharmacological sleep aids. However, these carry risks, such as delirium and falls, especially in elderly patients. A 2014 study found that out of 642 unique admissions, 26.2% received medication to aid sleep, with 68.5% having no known history of insomnia or prior sleep medication use. The most commonly prescribed sleep aids were trazodone (30.4%), lorazepam (24.4%), and zolpidem tartrate (17.9%).

Furthermore, 34.3% of patients with no prior history of sleep aid use left the hospital with a prescription for one. This highlights the potential long-term impact of introducing sleep medications during hospitalization. Delirium, or altered mental status, is a significant risk associated with sleep aids, which can lead to confusion and disorientation. This is particularly concerning in a hospital setting, where patients may already be vulnerable due to their underlying health conditions.

Additionally, the suboptimal administration timing of sleep medications can further increase the risk of adverse effects. In the study, 36.7% of sleep aids were given early (before 9 pm) or late (after midnight), which can disrupt the patient's circadian rhythm and exacerbate delirium. It is crucial for healthcare providers to carefully assess the need for sleep aids and explore alternative methods to improve sleep, such as those previously mentioned, before resorting to pharmacological interventions.

Overall, while pharmacological sleep aids may provide temporary relief for patients struggling to sleep in hospitals, they carry risks that can impact patient safety and recovery. It is important for healthcare providers to weigh the benefits against the potential drawbacks and prioritize non-pharmacological interventions whenever possible.

Hospital routines, like medication timing, can interrupt sleep

Spending a night in the hospital can be challenging as hospital routines, such as medication timing, can interrupt sleep. The timing of certain medications, blood draws, and blood pressure testing can cause unavoidable nighttime awakenings. For instance, certain antibiotics must be administered in the middle of the night, depending on when the first dose was given. Similarly, blood tests for antibiotic levels must be timed according to dosing, interrupting sleep.

Additionally, patients may experience side effects from medications that can keep them awake or make them drowsy during the day, disrupting their nighttime sleep. Furthermore, treatments and checkups during the night can also hinder a good night's rest. This includes vital checks, such as blood pressure monitoring, which can be coordinated with other procedures to minimize disruptions.

To improve sleep, patients can speak to their medical providers about minimizing non-essential nighttime tasks and adjusting medication schedules. Patients can also take proactive measures, such as limiting daytime napping, engaging in light physical activities, and avoiding caffeine after noon. Bringing familiar items, such as pillows or pajamas, can enhance comfort and aid sleep. Hospitals are also implementing changes to improve patient sleep, recognizing the importance of rest for recovery and health outcomes.

Environmental factors like light and noise can cause frequent awakenings

Noise is another significant environmental factor that can disturb patients' sleep. Hospitals are notoriously noisy places, with sounds from staff voices, cleaning machines, beeping monitors, pumps, and ventilators, and other patients. These noises can make it challenging for patients to fall asleep or stay asleep. To reduce noise disturbances, patients can ask for their door to be closed or use earplugs to block out the sound. Hospitals can also implement measures to reduce noise, such as coordinating activities to minimise disruptions and promoting the importance of quietness at night.

In addition to light and noise, other environmental factors can contribute to frequent awakenings in hospitals. For example, the timing of certain medications, blood draws, and vital sign checks may interrupt patients' sleep. Hospitals can improve this by rescheduling these activities to minimise nighttime disruptions. Additionally, patients should limit daytime napping and avoid caffeine after noon to improve their chances of sleeping well at night.

It is important for hospitals to address these environmental factors to create a more conducive environment for patients' sleep. Adequate sleep is essential for patients' overall health, recovery, and sense of well-being. By reducing light and noise disturbances and improving nighttime routines, hospitals can enhance patients' sleep quality and improve health outcomes.

Patients can improve sleep with items from home and relaxation techniques

Spending a night in the hospital usually means you won't get much sleep due to noise, bright lights, and nighttime interruptions. However, patients can improve their sleep quality by adopting various techniques and bringing items from home.

Firstly, patients should try to maintain their normal sleep schedule and circadian rhythm. During the day, keeping the window shades open for natural light is recommended, and during sleeping hours, the room should be dark. An eye mask can be useful if exposure to light at night is unavoidable.

Bringing items from home, such as a favourite blanket, pillow, or pyjamas, can also enhance comfort and familiarity, improving sleep quality. Patients can also bring photos or listen to their favourite music to help them relax.

Additionally, patients should limit daytime napping as it can disrupt nighttime sleep. Getting out of bed and staying active during the day can help maintain the sleep schedule. It is also essential to avoid caffeine after noon and finish dinner at least three hours before bedtime.

Simple relaxation techniques such as deep breathing exercises and meditation can effectively promote sleep. Patients can also try listening to soothing music or white noise with headphones to block out hospital noise.

Frequently asked questions