1
|
Rinehart MC, Ghorashi S, Heavner MS, Tata A, Bathula M, Kelly S, Yeung SYA, Landolf K, So JY, Goel N, Grover BE. An assessment of a sleep aid and sleep promotion practices in hospitalized medical patients. J Am Pharm Assoc (2003) 2024; 64:102042. [PMID: 38382836 DOI: 10.1016/j.japh.2024.102042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Half of patients admitted to medicine units report sleep disruption, which increases the risk of sleep deprivation. Non-pharmacological interventions are the first step to improving sleep. However, utilization of sleep aids continues to be prevalent. Limited data are available on sleep aid prescribing practices across transitions of care. OBJECTIVES The aim of this study was to describe the current practices for assessing sleep and prescribing pharmacologic agents to promote sleep in the adult medicine population. METHODS This study was designed as a single-center, retrospective, observational cohort study of all patients discharged by the general medicine teams over a 3-month period (September 2019- November 2019). Prior to admission, inpatient and discharge prescriptions for sleep aids were recorded, and documentation of sleep assessments and non-pharmacological interventions were evaluated. RESULTS Of 754 patients included, 211 (28%) were prescribed a sleep aid while inpatient. During hospitalization, 124 (16%) patients had at least one documented sleep assessment, and only 22 (3%) were ordered the institutional non-pharmacological sleep promotion order set. The most prescribed sleep aid in inpatients was melatonin (50%), as well as prior to admission (35%) and at discharge (25%). Overall, the relative reduction in sleep aid prescriptions between admission and discharge was 67%. CONCLUSION Inpatient sleep aid prescribing is common in medical patients. Despite this, sleep assessments and the standard of care of non-pharmacological interventions are rarely utilized. Future efforts should focus on implementation of strategies to make sleep assessments and non-pharmacological sleep promotion routine and consistent in the inpatient setting.
Collapse
|
2
|
Longino A, Zero O, Lorenz ML. Things We Do for No Reason™: Pharmacological sleep aids for hospitalized patients with acute insomnia. J Hosp Med 2024; 19:62-65. [PMID: 37534692 DOI: 10.1002/jhm.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/27/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023]
Affiliation(s)
- August Longino
- Department of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Odette Zero
- Department of Family Medicine, Swedish First Hill Family Medicine Residency, Seattle, Washington, USA
| | - Matthew L Lorenz
- Department of Medicine and Pediatrics, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
- Departments of Medicine and Pediatrics, Rhode Island Hospital, Providence, Rhode Island, USA
| |
Collapse
|
3
|
Zarogoulidis P, Petridis D, Kosmidis C, Sapalidis K, Nena L, Matthaios D, Porpodis K, Kakavelas P, Steiropoulos P. Immunotherapy and Chemotherapy Versus Sleep Disturbances for NSCLC Patients. Curr Oncol 2023; 30:1999-2006. [PMID: 36826116 PMCID: PMC9955782 DOI: 10.3390/curroncol30020155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Cancer patients are known to experience sleep disturbances that differ between disease stages and treatments. Regarding lung cancer patients and immunotherapy, information on their sleep disturbances has been recently acquired, but no comparison has been made between different treatment modalities. PATIENTS AND METHODS We recruited 98 non-small cell lung cancer patients; 49 had programmed death-ligand 1 expression of ≥50% and received immunotherapy as first-line treatment and 49 had programmed death-ligand 1 expression in the range from 0-49 and received chemotherapy as first-line treatment. All patients were stage IV, but with no bone metastasis. Sleep disturbances were recorded through polysomnography and sleep questionnaires. RESULTS For immunotherapy patients with PD-L1 expression ≥ 50%, the disease response was rapid and the sleep disturbances decreased rapidly. On the other hand, for chemotherapy patients, the sleep disturbances remained for all those patients that had partial response and stable disease. It was noticed that chemotherapy drugs induce severe adverse effects. DISCUSSION In our study, it was observed that patients with complete response had reduced sleep disturbances in the case of immunotherapy patients. However, sleep disturbances continued for several patients in the chemotherapy group due to the adverse effects of chemotherapy drugs. IN CONCLUSION Immunotherapy drugs on their own do not induce sleep disturbances and, through treatment response, alleviate sleep disturbances in lung cancer patients.
Collapse
Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica Private Hospital, 851 05 Thessaloniki, Greece
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6977-2719-74
| | - Dimitrios Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 574 00 Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Lila Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | | | - Konstantinos Porpodis
- Pulmoanry Department, G. Papanikolaou General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Paschalis Kakavelas
- Intensive Care Unit (ICU), General Clinic Euromedica, 153 43 Thessaloniki, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| |
Collapse
|
4
|
|
5
|
Stewart NH, Arora VM. Sleep in Hospitalized Patients. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
6
|
Abstract
TOPIC Sleep deprivation in the intensive care unit setting. CLINICAL RELEVANCE The Society of Critical Care Medicine has identified sleep deprivation as a significant contributor to the development of delirium in adult patients in the intensive care unit. Thus, preventing and managing sleep deprivation is important in reducing the incidence of delirium in this patient population. A multifaceted and multidisciplinary approach to promoting sleep in the intensive care unit setting that includes sleep hygiene routines, nursing care plans, and appropriate medication regimens may improve patient outcomes, including reducing delirium. PURPOSE OF ARTICLE To review the current literature on sleep deprivation in the intensive care unit setting and present care guidelines in a concise format. This information may be helpful in the development of clinical tools and may guide future quality improvement projects aimed at reducing delirium through sleep promotion in critical care patients. CONTENT COVERED A review of current literature and national organization recommendations revealed consistent themes in addressing the problem of sleep deprivation in the intensive care unit. Modifiable and nonmodifiable risk factors included frequent care interactions, light, noise, medication effects, and preexisting sleep problems.
Collapse
Affiliation(s)
- Jessica Grimm
- Jessica Grimm is an associate professor, School of Nursing, College of Health and Human Services, Touro University Nevada, Henderson, Nevada
| |
Collapse
|
7
|
Wang X, Hua D, Tang X, Li S, Sun R, Xie Z, Zhou Z, Zhao Y, Wang J, Li S, Luo A. The Role of Perioperative Sleep Disturbance in Postoperative Neurocognitive Disorders. Nat Sci Sleep 2021; 13:1395-1410. [PMID: 34393534 PMCID: PMC8354730 DOI: 10.2147/nss.s320745] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/21/2021] [Indexed: 12/19/2022] Open
Abstract
Postoperative neurocognitive disorder (PND) increases the length of hospital stay, mortality, and risk of long-term cognitive impairment. Perioperative sleep disturbance is prevalent and commonly ignored and may increase the risk of PND. However, the role of perioperative sleep disturbances in PND remains unclear. Nocturnal sleep plays an indispensable role in learning, memory, and maintenance of cerebral microenvironmental homeostasis. Hospitalized sleep disturbances also increase the incidence of postoperative delirium and cognitive dysfunction. This review summarizes the role of perioperative sleep disturbances in PND and elucidates the potential mechanisms underlying sleep-deprivation-mediated PND. Activated neuroinflammation and oxidative stress; impaired function of the blood-brain barrier and glymphatic pathway; decreased hippocampal brain-derived neurotrophic factor, adult neurogenesis, and sirtuin1 expression; and accumulated amyloid-beta proteins are associated with PND in individuals with perioperative sleep disorders. These findings suggest that the improvement of perioperative sleep might reduce the incidence of postoperative delirium and postoperative cognitive dysfunction. Future studies should further investigate the role of perioperative sleep disturbance in PND.
Collapse
Affiliation(s)
- Xuan Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Dongyu Hua
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Xiaole Tang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Shan Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Rao Sun
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Zheng Xie
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Zhiqiang Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Yilin Zhao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Jintao Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Shiyong Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Ailin Luo
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| |
Collapse
|
8
|
Tiruvoipati R, Mulder J, Haji K. Improving Sleep in Intensive Care Unit: An Overview of Diagnostic and Therapeutic Options. J Patient Exp 2020; 7:697-702. [PMID: 33294603 PMCID: PMC7705839 DOI: 10.1177/2374373519882234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Good quality sleep is considered to be essential for healthy living and recovering from illness. It would be logical to think that good quality sleep is most required when a patient is critically ill in an intensive care unit (ICU). Several studies have demonstrated poor quality of sleep while the patients are in ICU. Subjective tools such as questionnaires while simple are unreliable to accurately assess sleep quality. Relatively few studies have used standardized polysomnography. The use of novel biological markers of sleep such as serum brain-derived neurotrophic factor concentrations may help in conjunction with polysomnography to assess sleep quality in critically ill patients. Attempts to improve sleep included nonpharmacological interventions including the use of earplugs, eye sleep masks, and pharmacological agents including ketamine, propofol, dexmedetomidine, and benzodiazepines. The evidence for these interventions remains unclear. Further research is needed to assess quality of sleep and improve the sleep quality in intensive care settings.
Collapse
Affiliation(s)
- Ravindranath Tiruvoipati
- Department of Intensive Care Medicine, Frankston Hospital, Frankston, Victoria, Australia
- School of Public Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Ravindranath Tiruvoipati, Department of Intensive Care Medicine, Frankston Hospital, Frankston, Victoria 3199, Australia.
| | - Juan Mulder
- Department of Respiratory and Sleep Medicine, Frankston Hospital, Frankston, Victoria, Australia
| | - Kavi Haji
- Department of Intensive Care Medicine, Frankston Hospital, Frankston, Victoria, Australia
- School of Public Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| |
Collapse
|
9
|
Jensen PS, Specht K, Mainz H. Sleep quality among orthopaedic patients in Denmark - A nationwide cross-sectional study. Int J Orthop Trauma Nurs 2020; 40:100812. [PMID: 33495139 DOI: 10.1016/j.ijotn.2020.100812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hospitalised patients sleep less and have a lower quality of sleep compared to patients who recover in their own home. Low sleep quality is associated with complications such as increased pain sensation, delirium and reduced rehabilitation capacity. PURPOSE To investigate patients' self-reported sleep quality and factors related to sleep quality during admission to a department of Orthopaedic Surgery. METHODS The Richard-Campbell Sleep Questionnaire was used to assess patients' sleep quality, measured using a VAS 0-100 scale, (a higher score indicating good sleep quality). The moderated Pittsburgh Sleep Quality Index assessed the most severe and frequent barriers to high sleep quality. RESULTS A total of 533 patients undergoing orthopaedic surgery participated. There was an overall mean sleep quality score of 54. The most common and severe factors impacting sleep quality were; waking during the night, difficulties falling asleep, waking early, waking for toileting or pain. The intensity of the pain was found to be proportional to the quality of sleep. CONCLUSION Patients reported their overall quality of sleep to be moderately good due to difficulties falling asleep, waking up during the night or early morning and having pain. The results call for better pain management and non-pharmacological nursing interventions to optimise sleep quality.
Collapse
Affiliation(s)
- Pia Søe Jensen
- Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
| | - Kirsten Specht
- Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark; Department of Orthopaedic Surgery, Hospital Sønderjylland, Aabenraa, Denmark; Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Hanne Mainz
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark; Danish Orthopaedic Nursing Knowledge and Science Centre (VIDOKS), Denmark
| |
Collapse
|
10
|
Astin F, Stephenson J, Wakefield J, Evans B, Rob P, Joanna G, Harris E. Night-time Noise Levels and Patients’ Sleep Experiences in a Medical Assessment Unit in Northern England. Open Nurs J 2020. [DOI: 10.2174/1874434602014010080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Hospital in-patients need sleep so that restorative process and healing can take place. However, over one third of in-patients experience sleep disturbance, often caused by noise. This can compromise patients’ perceptions of care quality and cause physical and psychological ill health.
Aims:
To assess 1) in-patients sleep quality, quantity, reported sources of sleep disturbance and their suggestions for improvement 2) objectively measure decibel levels recorded at night.
Methods:
This descriptive study conducted in a Medical Assessment Unit used multi-methods; a semi-structured ‘sleep experience’ questionnaire administered to a purposive sample of in-patients; recording of night-time noise levels, on 52 consecutive nights, using two calibrated Casella sound level meters.
Results:
Patient ratings of ‘in-hospital’ sleep quantity (3.25; 2.72 SD) and quality (2.91; 2.56 SD) was poorer compared to ‘home’ sleep quantity (5.07; 2.81 SD) and quality (5.52; 2.79 SD). The difference in sleep quality (p<0.001) and quantity (p<0.001) ratings whilst in hospital, compared to at home, was statistically significant. Care processes, noise from other patients and the built environment were common sources of sleep disturbance. Participants’ suggestions for improvement were similar to interventions identified in current research. The constant noise level ranged from 38-57 decibels (equivalent to an office environment), whilst peak levels reached a maximum of 116 decibels, (equivalent to banging a car door one metre away).
Conclusion:
The self-rated patient sleep experience was significantly poorer in hospital, compared to home. Noise at night contributed to sleep disturbance. Decibel levels were equivalent to those reported in other international studies. Data informed the development of a ‘Sleep Smart’ toolkit designed to improve the in-patient sleep experience.
Collapse
|
11
|
Stenveld F, Bosman S, van Munster BC, Beishuizen SJ, Hempenius L, van der Velde N, Smidt N, de Rooij SE. Melatonin, temazepam and placebo in hospitalised older patients with sleeping problems (MATCH): a study protocol of randomised controlled trial. BMJ Open 2019; 9:e025514. [PMID: 31122969 PMCID: PMC6537975 DOI: 10.1136/bmjopen-2018-025514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 03/14/2019] [Accepted: 03/19/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Hospitalised older patients frequently suffer from inadequate sleep, which can lead to patient distress and delayed recovery from acute illness or surgical procedure. Currently, no evidence-based treatments exist for sleeping problems in hospitalised older patients. Benzodiazepines, such as temazepam, are regularly prescribed by physicians, although they have serious side effects; for older patients in particular. Melatonin is proposed as a safe alternative for sleeping problems in hospitalised older patients, but the efficacy of melatonin is unclear in this population. Therefore, the aim of this study is to investigate the effects of melatonin and temazepam compared with placebo on sleep quality among hospitalised older patients with sleeping problems. METHODS AND ANALYSIS This study is a multicentre, randomised, placebo-controlled trial. A total of 663 patients will be randomised in a 1:1:1 fashion to receive either melatonin (n=221), temazepam (n=221) or placebo (n=221). The study population consists of hospitalised patients aged 60 years and older, with new or aggravated sleeping problems for which an intervention is needed. The primary outcome is sleep quality measured with the Leeds Sleep Evaluation Questionnaire (LSEQ). Secondary outcomes include sleep parameters measured with actigraphy and medication-related adverse effects. ETHICS AND DISSEMINATION This study was approved by the Medical Ethics Committee of the Academic Medical Centre Amsterdam, (No 2015_302). Study findings will be disseminated through presentations at professional and scientific conferences and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER NTR6908; Pre-results.
Collapse
Affiliation(s)
- Fiona Stenveld
- Department of Geriatric Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sjanne Bosman
- Department of Geriatric Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Geriatric Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Barbara C van Munster
- Department of Geriatric Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands
| | - Sara J Beishuizen
- Department of Internal Medicine, Geriatrics Section, Amsterdam Public Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - Liesbeth Hempenius
- Department of Geriatric Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Nathalie van der Velde
- Department of Internal Medicine, Geriatrics Section, Amsterdam Public Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - Nynke Smidt
- Department of Geriatric Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Epidemiology, University of Groningen, University Medical Centre, Groningen, The Netherlands
| | - Sophia E de Rooij
- Department of Geriatric Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Internal Medicine, Geriatrics Section, Amsterdam Public Health, Academic Medical Centre, Amsterdam, The Netherlands
| |
Collapse
|
12
|
Abstract
Hospitalized patients frequently have disordered and poor-quality sleep due to a variety of both intrinsic and extrinsic factors. These include frequent nighttime intrusions, insomnia related to pain and unfamiliar environments, dark conditions during the day with loss of natural light, and disruption of the natural sleep cycle due to illness. Sleep wake disturbances can result in a deleterious consequence on physical, emotional, and cognitive status, which may impact patient satisfaction, clinical recovery, and hospital length of stay. Despite this, clinicians frequently fail to document sleep disturbances and are generally unaware of the best practices to improve sleep quality in the hospital. A PubMed search was conducted using the terms: ("sleep and hospitalized patients") and ("sleep and hospitalization") to review the published data on the topic of sleep in hospitalized medical patients. The search was limited to English-language articles published between 2000 and 2018. Subsequent PubMed searches were performed to clarify the data described in the initial search, including the terms "hospital sleep protocols," "hospitalized patients sleep documentation," and "hospitalized patients sleep quality". The purpose of this review is to discuss sleep disturbances in hospitalized patients with a focus on causes of sleep disturbance, the effect of poor-quality sleep, high risk populations, considerations for surveillance and prevention, and pharmacologic and non-pharmacologic options for treatment.
Collapse
Affiliation(s)
- Anne Marie Morse
- Geisinger Commonwealth School of Medicine, Department of Child Neurology and Sleep Medicine Geisinger Medical Center, Janet Weis Children’s Hospital, 100 N. Academy Ave, Danville, PA 17820, USA
| | - Evin Bender
- Department of Neurology, Geisinger Medical Center, 100 N. Academy Ave, Danville, PA 17820, USA
| |
Collapse
|
13
|
Nomamiukor FO, Smith LJ, Vujanovic AA. Examining associations between sleep disturbance and distress tolerance in trauma-exposed psychiatric inpatients. Gen Hosp Psychiatry 2018; 55:84-89. [PMID: 30448742 DOI: 10.1016/j.genhosppsych.2018.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/09/2018] [Indexed: 10/28/2022]
Affiliation(s)
| | - Lia J Smith
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, TX, USA.
| |
Collapse
|
14
|
Lee J, Kim Y, Kim YL. Non-pharmacological therapies for sleep disturbances in people with Parkinson's disease: A systematic review. J Adv Nurs 2018; 74:1741-1751. [PMID: 29700848 DOI: 10.1111/jan.13694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 02/28/2024]
Abstract
AIM To determine the effectiveness of non-pharmacological therapies for sleep disturbances in people with Parkinson's disease (PD). BACKGROUND Sleep disturbances, which are common in people with PD, may diminish their quality of life. Non-pharmacological therapies are preferred over pharmacological therapies for improving sleep quality, owing to fewer adverse effects. DESIGN Systematic literature review. DATA SOURCES A systematic search of eight databases and hand searching was conducted for papers published between 1 January 2000 - 1 January 2016. REVIEW METHODS The Cochrane methods were followed. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool. RESULTS Eight studies were identified for data extraction. Therapeutic domains included physical exercise, cognitive behavioural and complementary interventions. Therapies in four of the eight studies significantly improved sleep quality and the unified PD rating scale score. Other studies showed no clear effects on sleep (N = 1), limited effects on sleep (N = 1) or effects in both the intervention and control groups, indicating that the intervention had no distinctive effects (N = 2). CONCLUSIONS The non-pharmacological intervention types and sleep-related measured outcomes were heterogeneous. Most therapies had inconsistent effects on sleep. The insufficient evidence for non-pharmacological treatments seems related to the unique motor-associated clinical features of PD, which restrict the use of physical exercise therapy, or to individual "wearing-off" periods, which limit group therapy. Further studies on non-pharmacological therapies are required to identify the best interventions for improving sleep quality in people with PD.
Collapse
Affiliation(s)
- JuHee Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Yonji Kim
- Graduate School, College of Nursing, Yonsei University, Seoul, Korea
| | - Yie Lin Kim
- Graduate School, College of Nursing, Yonsei University, Seoul, Korea
| |
Collapse
|
15
|
Abstract
Hospitalization is a period of acute sleep deprivation for older adults owing to environmental, medical, and patient factors. Although hospitalized patients are in need of adequate rest and recovery during acute illness, older patients face unique risks owing to acute sleep loss during hospitalization. Sleep loss in the hospital is associated with worse health outcomes, including cardiometabolic derangements and an increased risk of delirium. Because older patients are at risk of polypharmacy and medication side effects, a variety of nonpharmacologic interventions are recommended first to improve sleep loss for hospitalized older adults.
Collapse
Affiliation(s)
- Nancy H Stewart
- Creighton University Medical Center, 7500 Mercy Road, Omaha, NE 68124, USA
| | - Vineet M Arora
- Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 2007 AMB W216, Chicago, IL 60637, USA.
| |
Collapse
|
16
|
Ho A, Raja B, Waldhorn R, Baez V, Mohammed I. New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate. J Community Hosp Intern Med Perspect 2017; 7:309-313. [PMID: 29147474 PMCID: PMC5676971 DOI: 10.1080/20009666.2017.1374108] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022] Open
Abstract
Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors from day 3 to day 5 of their hospital stay. We excluded patients with a prior insomnia history. Results: Out of the 205 patients who met the inclusion criteria, 75 patients (36%) reported insomnia. Severe insomnia was present in 3% of patients. Difficulty in maintaining sleep is the most common symptom. Frequent staff disruptions due to blood draws and vital signs checks were reported by 68% as the cause of insomnia, followed by illness associated causes (64%) and sleep disruption due to noise and or brightness (23%). Patients with insomnia had more awakenings due to noise, brightness, and staff interruptions than those without insomnia (1.35 times vs. 0.9 times, p = 0.027). Patients with respiratory symptoms, cardiac monitoring, oxygen use, private rooms, and no sedative use did not have a higher insomnia risk. Patients with insomnia had significant lower satisfaction scores than patients without insomnia (4.53 vs. 4.05, p = 0.001) but did not have a different length of stay (6.18 vs. 6.19, p = 0.97). In 31% of patients with insomnia who were able to be contacted two weeks after discharge, 75% of them had insomnia resolution. Conclusion: New onset of insomnia occurred in 36% of hospitalized patients. Most common causes are staff disruption and disease symptoms. It was usually short-term and could decrease patients’ satisfaction score.
Collapse
Affiliation(s)
- An Ho
- Medicine Department, Medstar Harbor Hospital, Baltimore, MD, USA
| | - Bronson Raja
- Medicine Department, Medstar Harbor Hospital, Baltimore, MD, USA
| | - Richard Waldhorn
- Pulmonary and Critical Care Department, Medstar Georgetown University Hospital, Washington, DC, USA
| | - Valentina Baez
- Medicine Department, Medstar Harbor Hospital, Baltimore, MD, USA
| | - Idiris Mohammed
- Medicine Department, Medstar Harbor Hospital, Baltimore, MD, USA
| |
Collapse
|
17
|
Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue. Bone Marrow Transplant 2016; 52:279-284. [PMID: 27941775 PMCID: PMC5288285 DOI: 10.1038/bmt.2016.248] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 11/09/2022]
Abstract
Cognitive problems are a significant, persistent concern for patients undergoing hematopoietic stem cell transplant (HSCT). Sleep is important for many cognitive tasks; however, the relationship between sleep and cognitive problems for HSCT patients is unknown. This study examined the relationship between sleep and cognitive problems for HSCT patients from pre to post transplant. Patients undergoing HSCT (N=138) completed questionnaires at pre-transplant and during the 12 months following transplant. Questionnaires assessed sleep and cognitive problems as well as commonly co-occurring symptoms: depressive symptoms, fatigue and pain. Post hoc analyses examined the relationship of specific sleep problems with cognitive problems. Sleep problems covaried with cognitive problems even after controlling for depressive symptoms, fatigue and pain. Depressive symptoms and fatigue were also uniquely related to cognitive problems. Post hoc analyses suggest that sleep somnolence, shortness of breath, snoring and perceptions of inadequate sleep may contribute to the association found between sleep and cognitive problems. Findings suggest that sleep problems are associated with and may contribute to cognitive problems for HSCT patients. However, sleep problems are rarely screened for or discussed during clinic visits. Assessing and treating specific sleep problems in addition to depressive symptoms and fatigue may have implications for improving cognitive problems for HSCT patients.
Collapse
|
18
|
Kanji S, Mera A, Hutton B, Burry L, Rosenberg E, MacDonald E, Luks V. Pharmacological interventions to improve sleep in hospitalised adults: a systematic review. BMJ Open 2016; 6:e012108. [PMID: 27473952 PMCID: PMC4986185 DOI: 10.1136/bmjopen-2016-012108] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/15/2016] [Accepted: 07/04/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Patients often suffer from disturbed sleep in hospital. Poor-quality sleep in hospitalised patients has been associated with significant morbidity and pharmacological sleep aids are often prescribed. The objective of this systematic review is to evaluate the comparative efficacy and safety of pharmacological interventions used for sleep in hospitalised patients. SETTING/PARTICIPANTS We searched MEDLINE, Embase, the Cochrane database and grey literature for prospective studies that evaluated sleep in hospitalised adults after a pharmacological intervention. PRIMARY AND SECONDARY OUTCOME MEASURES Two reviewers assessed studies for inclusion and extracted data for efficacy outcomes, including sleep efficiency, sleep latency, sleep fragmentation and objectively measured sleep stage distribution. Risk of bias was assessed and meta-analyses were planned contingent upon homogeneity of the included studies. RESULTS After screening 1920 citations, 15 studies involving 861 patients were included. Medications studied included benzodiazepines, nonbenzodiazepine sedatives, melatonin, propofol and dexmedetomidine. Five studies were deemed to be of high quality. Heterogeneity and variable outcome reporting precluded meta-analysis in most cases. No consistent trends with respect to sleep efficiency, quality or interruptions were observed identifying a drug or drug class as superior to another or no treatment. Benzodiazepines appeared to be better than no treatment with respect to sleep latency, but this was not consistently demonstrated across all studies. Sleep stage distribution shows that sleep in hospital is dominated by stages N1 and N2. CONCLUSIONS There is insufficient evidence to suggest that pharmacotherapy improves the quality or quantity of sleep in hospitalised patients suffering from poor sleep. No drug class or specific drug was identified as superior even when compared to placebo or no treatment. Although 15 studies were included, the quality of evidence was limited by their quality and size. Larger, better-designed trials in hospitalised adults are needed.
Collapse
Affiliation(s)
- Salmaan Kanji
- Department of Pharmacy and Critical Care, The Ottawa Hospital, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Alexandru Mera
- Department of Pharmacy, Hôpital Montfort—The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Brian Hutton
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa Burry
- Department of Pharmacy, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Erin Rosenberg
- Department of Critical Care, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Erika MacDonald
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Pharmacy, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Vanessa Luks
- Department of Respirology, Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| |
Collapse
|
19
|
Dobing S, Frolova N, McAlister F, Ringrose J. Sleep Quality and Factors Influencing Self-Reported Sleep Duration and Quality in the General Internal Medicine Inpatient Population. PLoS One 2016; 11:e0156735. [PMID: 27280292 PMCID: PMC4900612 DOI: 10.1371/journal.pone.0156735] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 04/27/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Sleep quality in hospitalized Canadian General Internal Medicine patients is not well characterized. Our goals were to characterize hospital sleep quality in this population and identify potentially modifiable barriers to good sleep. METHODS GIM inpatients at a quaternary centre in Edmonton, Canada completed a survey, including the Verran-Snyder Halpern (VSH) questionnaire, to characterize the previous night's sleep within 48 hours prior to discharge. A chart review was also completed to assess comorbidities, discharge diagnoses, and pharmaceutical sleep aid use. RESULTS Patients reported significantly worse nighttime sleep duration in hospital compared with home (mean 5.5 versus 7.0 hours per night, p < 0.0001). Sleep quality was poor, as measured by the VSH disturbance (mean 371), effectiveness (190), and supplementation (115) subscales. Variables independently associated with poorer sleep duration in multivariable regression include prior diagnosis of sleep disorder and multi-patient occupancy rooms. Age, sex, admitting diagnosis, length of stay, frequency of vital checks, and use of sleep pharmaceuticals during the index hospitalization were not associated with sleep duration. The most frequently reported reasons for poor sleep included noise (59%), nursing interruptions (30%), uncomfortable beds (18%), bright lights (16%), unfamiliar surroundings (14%), and pain (9%). CONCLUSIONS Sleep quality for GIM inpatients is significantly worse in hospital than at home. There is a need to test non-pharmacologic interventions to address the most frequently identified factors causing poor sleep hygiene for GIM inpatients.
Collapse
Affiliation(s)
- Selina Dobing
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Natalia Frolova
- Division of General Internal Medicine, University of Alberta, Edmonton, Canada
| | - Finlay McAlister
- Division of General Internal Medicine, University of Alberta, Edmonton, Canada
| | - Jennifer Ringrose
- Division of General Internal Medicine, University of Alberta, Edmonton, Canada
- * E-mail:
| |
Collapse
|
20
|
Behavioral economics strategies for promoting adherence to sleep interventions. Sleep Med Rev 2015; 23:20-7. [DOI: 10.1016/j.smrv.2014.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 11/04/2014] [Accepted: 11/11/2014] [Indexed: 12/28/2022]
|
21
|
|
22
|
Tamrat R, Huynh-Le MP, Goyal M. Non-pharmacologic interventions to improve the sleep of hospitalized patients: a systematic review. J Gen Intern Med 2014; 29:788-95. [PMID: 24113807 PMCID: PMC4000341 DOI: 10.1007/s11606-013-2640-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 08/19/2013] [Accepted: 09/03/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Despite the known adverse effects of sleep deprivation on recovery from illness, studies have shown that sleep deprivation remains an incompletely addressed problem among acutely ill inpatients. Behavioral interventions are recommended as first-line therapy prior to using pharmacologic therapy due to the side effects of sedative hypnotics. The objective of this systematic review was to identify non-pharmacologic interventions that have been used to improve sleep quality and quantity of non-intensive care unit (ICU) inpatients. DATA SOURCES PubMed, Embase, Web of Science, CINAHL, and Cochrane Library through January 2013; manual searches of reference lists. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, INTERVENTIONS Any study in which a non-pharmacologic intervention was conducted in a general inpatient setting, and nighttime sleep quantity or quality was assessed. STUDY APPRAISAL AND SYNTHESIS METHODS Information on study design, populations, interventions, comparators, outcomes, time frame, and risk of bias were independently abstracted by two investigators. RESULTS 13 intervention studies with 1,154 participants were included. Four studies were randomized controlled trials. Seven studies had a low to medium risk of bias, and there was significant heterogeneity in the interventions. Relaxation techniques improved sleep quality 0-38%, interventions to improve sleep hygiene or reduce sleep interruptions improved sleep quantity 5%, and daytime bright light exposure improved sleep quantity 7-18%. LIMITATIONS The heterogeneity in the types and dose of interventions, outcome measures, length of follow-up, differences in patient populations, and dearth of randomized trials may dilute effects seen or make it more difficult to draw conclusions. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS There is insufficient to low strength of evidence that any non-pharmacologic intervention improves sleep quality or quantity of general inpatients. Further studies are needed in this area to guide clinicians.
Collapse
Affiliation(s)
- Ruth Tamrat
- Division of General Internal Medicine, Johns Hopkins School of Medicine, 2024 E. Monument St, Suite 1-500W, Baltimore, MD, 21287, USA,
| | | | | |
Collapse
|
23
|
Abstract
Insomnia is a common sleep disorder which has been shown to adversely affect outcomes in hospitalized patients. This article reviews the available classes of medications that may be considered in the treatment of insomnia in the hospital setting.
Collapse
Affiliation(s)
- Jennifer Kelly
- Clinical Pharmacy Specialist, Residential Rehabilitation Treatment Programs (RRTPs), (A-PRRTP, CWT/TR, DRRTP, G-PRRTP, STARR Programs), Albuquerque, NM
| |
Collapse
|
24
|
Adachi M, Staisiunas PG, Knutson KL, Beveridge C, Meltzer DO, Arora VM. Perceived control and sleep in hospitalized older adults: a sound hypothesis? J Hosp Med 2013; 8:184-90. [PMID: 23504939 PMCID: PMC3764606 DOI: 10.1002/jhm.2027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 01/02/2013] [Accepted: 01/16/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND/OBJECTIVES To examine the associations between perceived control over sleep, noise levels, sleep duration, and noise complaints in a cohort of hospitalized adults. DESIGN Prospective cohort study. SETTING General medicine ward in an academic medical center. PARTICIPANTS One hundred eighteen hospitalized patients age 50 years and over (mean age, 65 years; 57% female; 67% African American). MEASUREMENTS Sleep duration was measured via wrist actigraphy, and noise levels in patient rooms were measured via sound monitors. Validated questionnaires were used to assess sleep characteristics at baseline and sleep quality for each night. Perceived control over sleep was measured at baseline using the Sleep Self-Efficacy (SSE) scale (range 9-45). RESULTS The mean SSE score was 32.1 (standard deviation, 9.4), and the median score was 34 (interquartile range, 24-41). Average sleep duration for patients in the hospital was 333 minutes (5.5 hours). Forty-two percent of patients complained of noise disrupting their sleep. Linear regression clustered by subject showed that above median SSE was associated with longer sleep duration (+55 minutes 95% confidence interval [CI]: 14, 97; P = 0.010). This association remained significant after controlling for objective noise levels and patient demographics (+50 minutes 95% CI: 11, 90; P = 0.014). In logistic regression controlling for noise level and patient demographics, those patients with high SSE were 51% less likely to complain of noise disruptions (odds ratio: 0.49; 95% CI: 0.25, 0.96; P = 0.039). CONCLUSION Higher perceived control over sleep is associated with longer sleep duration, better sleep quality, and fewer reports of noise disruptions. In addition to noise control, interventions to boost perceived control may improve in-hospital sleep.
Collapse
Affiliation(s)
- Marie Adachi
- Pritzker School of Medicine, University of Chicago
| | | | - Kristen L. Knutson
- Department of Medicine, University of Chicago
- Sleep, Metabolism and Health Center, University of Chicago
| | | | | | - Vineet M. Arora
- Department of Medicine, University of Chicago
- Sleep, Metabolism and Health Center, University of Chicago
| |
Collapse
|
25
|
Karkare K, Sinha S, Taly AB, Rao S. Prevalence and profile of sleep disturbances in Guillain-Barre Syndrome: a prospective questionnaire-based study during 10 days of hospitalization. Acta Neurol Scand 2013; 127:116-23. [PMID: 22642612 DOI: 10.1111/j.1600-0404.2012.01688.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2012] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sleep disturbances in Guillain-Barre Syndrome (GBS), though common, have not received focused attention. OBJECTIVES To study frequency and nature of sleep disturbances in patients with GBS, using validated questionnaires, and analyze the contributing factors. MATERIALS AND METHODS This prospective study included 60 patients fulfilling National Institute of Neurological and Communicative Diseases and Stroke (NINCDS) criteria for GBS (mean age: 32.7 ± 12.9 years; median: 30 years; M:F = 46:14), evaluated from 2008 to 2010. Data regarding sleep were collected on 10 consecutive days following admission using Richard Campbell Sleep score, St Mary's Hospital Sleep Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) and correlated with various possible contributing factors like pain, paresthesia, anxiety, depression, autonomic dysfunctions, severity of disease, and therapeutic interventions among others. OBSERVATIONS Qualitative and quantitative sleep disturbances were rather frequent and involved over 50% patients: abnormal PSQI - 13.3%, abnormal score on Richard scale - 51.6%, abnormal sleep onset latency - 35%, sleep fragmentation - 40%, and reduced sleep duration - 46.6%. The symptoms were severe during the first week of hospitalization and reduced thereafter. Sleep disturbances as scored on Richard scale significantly correlated with anxiety, pain, paresthesia, and severity of immobility (P < 0.05) but not with depression and use of analgesics or antineuritic drugs. CONCLUSIONS This study first of its kind suggests that sleep disturbance in GBS is frequent, multi-factorial, often disturbing, and varies during the course of illness. Routine enquiry into the sleep disturbances and timely intervention may reduce morbidity and improve their quality of life.
Collapse
Affiliation(s)
- K. Karkare
- Departments of Neurology; National Institute of Mental Health and NeuroSciences (NIMHANS); Bangalore; Karnataka; India
| | - S. Sinha
- Departments of Neurology; National Institute of Mental Health and NeuroSciences (NIMHANS); Bangalore; Karnataka; India
| | - A. B. Taly
- Departments of Neurology; National Institute of Mental Health and NeuroSciences (NIMHANS); Bangalore; Karnataka; India
| | - S. Rao
- Departments of Biostatistics; National Institute of Mental Health and NeuroSciences (NIMHANS); Bangalore; Karnataka; India
| |
Collapse
|
26
|
|
27
|
Rankin K, Brakoulias V. Patterns of hypnotic medication use for sleep disturbance amongst hospital inpatients. Australas Psychiatry 2012; 20:301-4. [PMID: 22773413 DOI: 10.1177/1039856212448102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of this article is to examine patterns of temazepam prescribing amongst inpatients at a Sydney teaching hospital. METHOD The study involved a retrospective file audit of 98.8% (n=410) of patients discharged from psychiatry, medical, surgical and obstetric and gynaecology wards of Nepean Hospital during a one-week period. Data was collected on patient demographics, temazepam and other sedative-hypnotic use, falls risk and analgesia use. RESULTS Sixteen per cent (n=64) of patients were prescribed temazepam during their stay. All patients from the psychiatry wards had been prescribed temazepam. Fifteen per cent (n=6) of falls risk patients had been prescribed temazepam. Temazepam prescription was associated with an increased length of stay, psychiatry and surgical wards, and higher use of analgesia. CONCLUSIONS Temazepam continues to be a frequently prescribed medication in the acute psychiatry setting. Its frequent prescription to patients in surgical wards and to those prescribed analgesic agents indicates that it still has a role in settling patients to sleep in the hospital setting.
Collapse
Affiliation(s)
- Katherine Rankin
- Sydney Medical School-Nepean, University of Sydney, Sydney, NSW, Australia.
| | | |
Collapse
|
28
|
Affiliation(s)
- Kevin Morgan
- Clinical Sleep Research Unit, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire.
| | | | | |
Collapse
|
29
|
Tendas A, Niscola P, Cupelli L, Giovannini M, Scaramucci L, Ales M, Morino L, Dentamaro T, de Fabritiis P. Sleep complaints in hospitalized Italian patients with hematological malignancies. Intern Med 2010; 49:1689; author reply 1391. [PMID: 20686322 DOI: 10.2169/internalmedicine.49.3747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|