Dev Patel

IR I P-3 / English 10

3/29/19

#11

Data and Project Timeline

Project Summary:

Based on literature and studies collected regarding the direct causes, effects, and potential
solutions of inpatient sleep deprivation, the hypothesis can be reasonably formed that by
focusing on the specifically investigated consequences and causes, effective strategies can be
implemented that do not disrupt the hospital environment.

Data Collection:
a. Metacognitive Research- Review and Analysis of Existing Literature- Studies on
sleep quality, quantity, sleep-disturbing factors, and sleep-promotion strategies
Goals:
4/10: Finish honing and polishing based of display board feedback
4/12: Began analysis and connections between 10 studies and contact advisor with tentative
results
Spring Break: Try to update paper and replace sources with 10 studies
4/24: Consolidate progress over spring break and incorporate advisor feedback
5/1: Finalize paper

Accomplishments:
3/8: Gathered 7 Inpatient Sleep Studies+Observations

3/15: Gathered total of 10 studies and other relevant data+Observation

3/22: Finished annotation and citation of 10 Data Sources

3/29: Began connections and in-depth analysis of studies for lit review
 Dev Patel

IR I P-3 / English 10

3/29/19

#11

4/5: Finished data collection, metacog review, and results, working on final analysis and
display board

4/14: Finish all literature review and complete high-quality display board

Results

Year Study Sample Method Results

Study 1 2017 24 medical unit Interview “Interview responses revealed 4 themes with related
staff, 14 patients subthemes: (1) The overnight medical intensive care unit
environment does affect sleep, (2) nonenvironmental
factors such as difficult emotions and anxiety also affect
sleep, (3) respondents’ perceptions about sleep quality in
the medical intensive care unit were highly variable, and
(4) suggestions for sleep improvement included
reassuring patients and care-clustering strategies”

Study 2 2018 32 patients Randomized “The four intervention groups presented improved quality
Intervention of sleep and health-related quality of life at the end of the
intervention period (12 weeks) and at the follow-up
occurring in the 24th week, though the differences found
between the groups were not statistically significant.”

Study 3 2016 42 articles Literature “Noise is a modifiable cause of some sleep disruptions in
Review hospitals, and when reduced can lead to more sleep.
Earplugs and eye masks may help, but changing the sound
and light environment is more effective. Calming music
in the evening has been shown to be effective as well as
daytime bright light exposure. Nursing care activities
cause sleep disruption, but efforts at limiting interventions
have not been demonstrated to improve sleep conditions.”
 Dev Patel

IR I P-3 / English 10

3/29/19

#11

Study 4 2013 57 patients Observational, “The quantity and quality of sleep in intensive care
Questionnaire patients are poor and may be related to noise, critical
illness itself and treatment events that disturb sleep.The
results suggest that a sound reduction program is required
and other interventions to improve clinical practices to
promote sleep in intensive care patients.”

Study 5 2018 32 patients Cross-sectional “There is a high prevalence of poor sleep among patients
admitted to the ICU. There is a dire need to minimize
untimely interventions and design nonpharmacological
techniques to allow patients to sleep comfortably.”

Study 6 2014 103 patients in Observational, “The mean equivalent continuous noise level for 24 hours
29 wardrooms Questionnaire was 63.5 decibel A (dBA), which was far higher than 30
dBA recommended by the World Health Organization for
hospital wardrooms. Other patients sharing a room were
perceived as the most common source of noise by the
patients, which was usually preventable. Of the patients in
the study, 86% had bad sleep as...the sleep disturbance
was significantly correlated with increasing noise levels
in a dose response manner.”

Study 7 2004 50 patient Randomized “Data consisted of interactions during 147 nights. The
records Review mean number of care interactions per night was 42.6
...interactions were most frequent at midnight and least
frequent at 3 AM. Only 9 uninterrupted periods of 2 to 3
hours were available for sleep...frequency of interactions
correlated significantly with patients’ acuity score. A
sleep-promoting intervention was documented for only 1
of the 147 nights...”

Study 8 2018 672 beds in 15 Cross-sectional “Patients reported a mean reduction in hospital sleep
clinical units duration, compared to home, of 1.8h...the proportions of
patients reporting their sleep quality to be poor/very poor,
fair and of good quality were 41.6, 34.2 and 24.2%
respectively. Patients, nurses and observers all reported
the main factors associated with poor sleep as clinical
 Dev Patel

IR I P-3 / English 10

3/29/19

#11

care interventions (34.3%) and environmental noise

(32.1%). Noise levels in all 15 clinical areas exceeded
WHO recommended levels of < 30 dB [A] by 36.7 to
82.6%...”

Study 9 2018 2005 patients Cross-sectional “Compared with habitual sleep at home, the total sleep
time in the hospital was 83 minutes shorter. The mean
number of nocturnal awakenings was 2.0 times at home
vs 3.3 times during hospitalization. Patients woke up 44
minutes earlier than their habitual wake-up time at home.
A total of 1344 patients reported having been awakened
by external causes, which in 718 (35.8%) concerned
hospital staff. All aspects of sleep quality measured...were
rated worse during hospitalization than at home. The most
reported sleep-disturbing factors were noise of other
patients, medical devices, pain, and toilet visits.”

Study 10 2015 1238 patients Observational Self-reported unsound sleep is common among
hospitalized patients with an infection-related diagnosis,
is associated with less advanced age and is often
attributed to staff disruptions, pain and/or anxiety.
Interventions at improving sleep quality in this patient
population seem warranted.