Minimizing Sleep Disruptions in the Hospital

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Many patients in the hospital complain of difficulty sleeping at night.
They cite the uncomfortable hospital bed mattresses, and the anxiety that comes with being hospitalized.
Patients also complain of other disruptions to their sleep: nurses and other staff waking them up to take vital signs, administer medications, or draw blood.
Some types of sleep interruptions are part of being a patient in the hospital and cannot be avoided, but in some cases interruptions can be managed, increasing the chances that a patient can achieve a restful sleep during the night.
Upon admission to the hospital, patients and their families should discuss concerns about sleep and rest with the admitting physicians.
If the physicians believe the patient's vital signs (the patient's blood pressure, temperature, heart rate and breaths per minute, among others) are not stable, the patient will require active monitoring and sleep disruptions cannot be avoided.
But if the hospital physicians believe the patient's vital signs are stable, the patient and family members could ask the doctors if they can write orders to minimize disruptions to the patient's sleep during certain hours, say 10:00 p.
m.
through 6:00 a.
m.
Obtaining such a physician order, however, is just one step in the process towards achieving a good night's sleep.
Each evening, patients and family members should discuss with their nurse the types of interruptions the nurse can foresee over the next eight to ten hours.
To facilitate this discussion, patients and family members can ask the following types of questions.
Are there medications scheduled during the overnight hours? If so, can these medications be given during the day? If vital signs such as blood pressure need to be taken, and/or blood drawn, what time will these be done? Can these tasks be done at the same time as nursing assessments of the patient? Also, importantly, can the patient's door be closed to shut out hallway noise? The timing of such a discussion with the nurse is also important.
Many hospital nursing shifts at night begin at 11:00 p.
m.
and end at 7:00 a.
m.
the following morning.
The nurse assigned to the patient during the night shift will be the nurse best able to help the patient sleep during these hours.
Accordingly, if a patient wants to go to sleep at ten o'clock p.
m.
, the patient should work with the evening shift nurse to determine if interruptions can be limited between that time and the beginning of the night shift.
Upon commencement of the night shift, the patient can have a similar discussion with the night shift nurse.
Communication with the nursing staff is the key, and since the nursing staff can change with each shift, these discussions will have to be repeated with the new nurses the following night.
Ideally, disruptions to the sleep of a stable patient can be limited to one or two times during the night.
The specifics of each patient's situation differ, of course.
The ability to minimize sleep disruptions are limited if there is concern the patient will fall going to the bathroom; in these situations, the nursing staff will monitor the patient more closely.
If the patient's heart is being monitored using a telemetry box, there may be unplanned interruptions if an unexpected heart rhythm develops or if the monitoring leads come off.
Issues like these, and others like them, should be discussed beforehand with the patient's doctors and nurses.
Hospitalization is a stressful event for patients and their families.
To regain their health, patients need to sleep, which can be difficult in the hospital.
If a patient's physicians believe the patient's vital signs are stable, they could write orders to minimize disruptions to the patient's sleep.
Patients and their families can discuss these orders with their nurses to determine how best to implement these orders within the context of the patient's care, with the goal of minimizing interruptions during the night and helping the patient obtain a restful sleep.
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