Megan A Miller1, Brenna N Renn2, Frances Chu3, Nicole Torrence4. 1. Rehabilitation Care Service, VA Puget Sound -Seattle Division, Seattle, WA, United States of America. Electronic address: Megan.miller5@va.gov. 2. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States of America. 3. University of Washington Health Sciences Library, Seattle, WA, United States of America. 4. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States of America; Geriatrics and Extended Care Service, VA Puget Sound - Seattle Division, Seattle, WA, United States of America.
Abstract
OBJECTIVE: Poor sleep is highly prevalent in inpatient medical settings and has been associated with attenuated healing and worsened outcomes following hospitalization. Although nonpharmacological interventions are preferred, little is known about the best way to intervene in hospital settings. METHOD: A systematic review of published literature examining nonpharmacological sleep interventions among inpatients in Embase, PsycINFO and PubMed in accordance with PRISMA guidelines. RESULTS: Forty-three of the 1529 originally identified manuscripts met inclusion criteria, encompassing 2713 hospitalized participants from 18 countries comprised of psychiatric and older adult patients living in hospital settings. Main outcomes were subjective and objective measures of sleep duration, quality, and insomnia. CONCLUSIONS: Overall, the review was unable to recommend any specific intervention due to the current state of the literature. The majority of included research was limited in quality due to lack of controls, lack of blinding, and reliance on self-reported outcomes. However, the literature suggests melatonin and CBT-I likely have the most promise to improve sleep in inpatient medical settings. Additionally, environmental modifications, including designated quiet time and ear plugs/eye masks, could be easily adopted in the care environment and may support sleep improvement. More rigorous research in nonpharmacological sleep interventions for hospitalized individuals is required to inform clinical recommendations. Published by Elsevier Inc.
OBJECTIVE: Poor sleep is highly prevalent in inpatient medical settings and has been associated with attenuated healing and worsened outcomes following hospitalization. Although nonpharmacological interventions are preferred, little is known about the best way to intervene in hospital settings. METHOD: A systematic review of published literature examining nonpharmacological sleep interventions among inpatients in Embase, PsycINFO and PubMed in accordance with PRISMA guidelines. RESULTS: Forty-three of the 1529 originally identified manuscripts met inclusion criteria, encompassing 2713 hospitalized participants from 18 countries comprised of psychiatric and older adult patients living in hospital settings. Main outcomes were subjective and objective measures of sleep duration, quality, and insomnia. CONCLUSIONS: Overall, the review was unable to recommend any specific intervention due to the current state of the literature. The majority of included research was limited in quality due to lack of controls, lack of blinding, and reliance on self-reported outcomes. However, the literature suggests melatonin and CBT-I likely have the most promise to improve sleep in inpatient medical settings. Additionally, environmental modifications, including designated quiet time and ear plugs/eye masks, could be easily adopted in the care environment and may support sleep improvement. More rigorous research in nonpharmacological sleep interventions for hospitalized individuals is required to inform clinical recommendations. Published by Elsevier Inc.
Authors: Michael D Wirth; Angela Jessup; Gabrielle Turner-McGrievy; Nitin Shivappa; Thomas G Hurley; James R Hébert Journal: Sleep Date: 2020-11-12 Impact factor: 5.849
Authors: Michael D Wirth; Desta Fekedulegn; Michael E Andrew; Alexander C McLain; James B Burch; Jean E Davis; James R Hébert; John M Violanti Journal: J Sleep Res Date: 2021-12-29 Impact factor: 5.296