Sleep disturbance among patients in hospital:
Implication for nursing care
This descriptive study was aimed at determining the pattern, quantity and quality of sleep and the prevalence, causes and effects of sleep deprivation/disturbance among patients hospitalized in two hospitals in Calabar. A prospective design was used, and 183 adult patients admitted into two hospitals and 80 nurses caring for them, were selected purposively and enrolled in the study. Patients’ sleep data were collected using an observation checklist (the sleep Behaviour Observational Tool–SBOT) and a patients’ self-report interview schedule (Sleep Quality Tool-SQT). Nurses’ data were collected through a structured questionnaire and examination of nurses’ night reports. Patients’ sleep was significantly disturbed during early period of hospitalization. Sleep disturbance was in the form of delayed onset of sleep or early awakening, both of which resulted in a short duration of total sleep time. Although sleep quantity and quality improved significantly as from the 7th day of admission, patients still reported inadequate feeling of restfulness in the morning. Identified causes of poor sleep in the hospital included environmental factors (bright lights, noise, heat, cold, disturbance by mosquitoes), frequent awakening by nurses for procedures and discomforts due to the illness. Nurses reported sleep difficulty in only 25.1% and 79.2% of patients themselves reported it. Such reports from nurses did not indicate duration of total sleep time, pattern of sleep disturbance. The need for both the medical and nursing teams to re-asses the habit of interrupting patients’ sleep for certain procedures and treatments is suggested. This re-assessment will enable them put in place measures that will allow patients to have un-interrupted sleep as much as possible if the procedures, prescribed and carried out are not absolutely necessary at night.
The need for sleep in human beings is universal and basic because sleep serves a restorative function for the body and mind. All individuals, well and ill, require adequate sleep times sleep disturbance especially insomnia, occurs. Insomnia is among the most frequent health complaints brought to the attention of healthcare providers1. Prevalence estimates are highest among pregnant women2, adolescents3, older adults especially menopausal women1,4, and patients with cancer5,6. Correlates of poor sleep include environmental factors (noise, excessive heat or cold, bright lights, frequent awakening for treatment etc.) and personal factors (pain itching, fever, patient’s underlying illness, medication used in treatment, etc). Hospitalization is detrimental to obtaining adequate sleep, and the critically ill are particularly vulnerable to sleep disturbance7,8. This is because the sleep of hospitalized patients is usually fragmented by frequent awakening episodes associated with nursing procedures. Sleep deprivation adversely affects...