Sleep quality among inpatients of Spanish public hospitals.

Sleep is a complex process and is needed both in health and illness. Deprivation of sleep is known to have multiple negative physiological effects on people's bodies and minds. Despite the awareness of these harmful effects, previous studies have shown that sleep is poor among hospitalised patients. We utilized an observational design with 343 patients recruited from medical and surgical units in 12 hospitals located in nine Spanish regions. Sociodemographic and clinical characteristics of patients were collected. Sleep quality at admission and during hospitalisation was measured by the Pittsburgh Sleep Quality Index. Sleep quantity was self-reported by patients in hours and minutes. Mean PSQI score before and during hospitalisation were respectively 8.62 ± 4.49 and 11.31 ± 4.04. Also, inpatients slept about an hour less during their hospital stay. Lower educational level, sedative medication intake, and multi-morbidity was shown to be associated with poorer sleep quality during hospitalisation. A higher level of habitual physical activity has shown to correlate positively with sleep quality in hospital. Our study showed poor sleep quality and quantity of inpatients and a drastic deterioration of sleep in hospital versus at home. These results may be helpful in drawing attention to patients' sleep in hospitals and encouraging interventions to improve sleep.

Detection of factors influencing circadian rhythms on Intensive Care inpatients and hospitalization: Protocol for an observational study.

AIMS: Identify the prevalence of circadian health disorders in ICU and hospitalized patients. Stablish the relationship of the circadian system with light, temperature, noise and nursing activities. BACKGROUND: Commonly, self-assessment through subjective questionnaires is used for research about sleep quality. However, more reliable and valid measures should be applied objectively to find out the real prevalence of the problem. There is a negative relationship between circadian rhythms and hospitalization. In this study, we will analyse sleep patterns and hospital environments to implement measures to improve the quality of care related to sleep. DESIGN: Descriptive observational study. It is estimated that 975 patients from 13 hospitals need to be recruited from ICU and hospitalization units. The sample should meet the following criteria: Patients over 18 admitted to ICU and medical units, length of stay between 96-148 hr, with no visual, hearing or moderate-severe cognitive impairment. Variables: Sleep variables are collected with an electronic device (named Kronowise® and Kronobed®), circadian and infrared light exposure, environmental noise, temperature, unit structural characteristics, nursing care (from 0 to 6 a.m.) and, characteristics of hospitalization period. The study, registered on Clinical Trials, initiated in December 2019 and it will continue up to December 2022. DISCUSSION: Using objective and subjective measures of sleep and circadian rhythms, this study will shed light on the factors that negatively affect the hospitalized patients' sleep quality and circadian health. The ultimate goal is to design hospital guidelines to minimize the adverse effects on the dependent variables studied. Arguably, these guidelines will contribute to reducing the risk of these alterations and it will also serve to improve the nursing activities. CONCLUSION: We expect to obtain adequate results for the creation of a protocol to improve the circadian health, quality of care and health outcomes related to sleep in patients.