Winters Benjamin, Serpas Dylan, Fullmer Niko, Hughes Katie, Kincaid Jennifer, Rosario Emily R, Schnakers Caroline
Department of Psychology, University of California, Los Angeles, CA 90095, USA.
Department of Psychology, University of South Florida, Tampa, FL 33620, USA.
Brain Sci. 2023 Apr 25;13(5):718. doi: 10.3390/brainsci13050718.
In this preliminary, longitudinal study, our objective was to assess changes in sleep quality during an inpatient stay in a rehabilitation setting in the United States and to relate changes to patients' demographic and clinical characteristics (i.e., age, gender, BMI, ethnicity, reason for hospitalization, pre-hospital living setting, prior diagnosis of sleep disorders, and mental health status).
A total of 35 patients participated in this preliminary study (age = 61 ± 16 years old, 50% <65; BMI = 30 ± 7 kg/m; 51% female; 51% Caucasian). The average length of hospitalization was 18 ± 8 days. Reasons for hospitalization included orthopedic-related issues (28%), spinal cord injury (28%), stroke (20%), and other (23%). In this sample, 23% had prior sleep disorders (mostly sleep apnea), and 60% came from an acute care unit. Patients' sleep quality was assessed using the Pittsburgh sleep quality index (PSQI) at admission and before discharge. Demographic and medical data were collected. Patients' mental health status was also assessed at the same intervals. Nighttime sound levels and the average number of sleep disturbances were also collected throughout the study (6 months).
Our data revealed that most patients had poor sleep (PSQI > 5) at admission (86%) and discharge (80%). Using a repeated ANOVA, a significant interaction was obtained between sleep quality and the presence of a diagnosed sleep disorder [F (1, 33) = 12.861, = 0.001, η = 0.280]. The sleep quality of patients with sleep disorders improved over their stay, while the sleep of patients without such disorders did not. The mean nighttime sound collection level averages and peaks were 62.3 ± 5.1 dB and 86.1 ± 4.9 dB, respectively, and the average number of sleep disturbances was 2.6 ± 1.1.
The improved sleep observed in patients with vs. without sleep disorders might be related to the care received for treating such disorders over the stay. Our findings call for the better detection and management of poor sleep in acute inpatient rehabilitation settings. Furthermore, if our findings are replicated in the future, studies on the implementation of quiet times for medical staff, patients, and family should be performed to improve sleep quality in the inpatient rehabilitation setting.
在这项初步的纵向研究中，我们的目的是评估美国康复机构住院期间睡眠质量的变化，并将这些变化与患者的人口统计学和临床特征（即年龄、性别、体重指数、种族、住院原因、院前生活环境、既往睡眠障碍诊断以及心理健康状况）相关联。
共有35名患者参与了这项初步研究（年龄 = 61 ± 16岁，50% <65岁；体重指数 = 30 ± 7 kg/m²；51%为女性；51%为白种人）。平均住院时间为18 ± 8天。住院原因包括骨科相关问题（28%）、脊髓损伤（28%）、中风（20%）以及其他（23%）。在这个样本中，23%有既往睡眠障碍（主要是睡眠呼吸暂停），60%来自急性护理单元。在入院时和出院前使用匹兹堡睡眠质量指数（PSQI）评估患者的睡眠质量。收集人口统计学和医疗数据。也在相同时间间隔评估患者的心理健康状况。在整个研究（6个月）期间还收集夜间声音水平和睡眠干扰的平均次数。
我们的数据显示，大多数患者在入院时（86%）和出院时（80%）睡眠质量较差（PSQI > 5）。使用重复方差分析，在睡眠质量和已诊断睡眠障碍的存在之间获得了显著的交互作用[F(1, 33) = 12.861, p = 0.001, η² = 0.280]。有睡眠障碍的患者在住院期间睡眠质量有所改善，而没有此类障碍的患者睡眠质量没有改善。夜间声音收集的平均水平和峰值分别为62.3 ± 5.1 dB和86.1 ± 4.9 dB，睡眠干扰的平均次数为2.6 ± 1.1。
有睡眠障碍与无睡眠障碍的患者相比，观察到的睡眠改善可能与住院期间针对此类障碍所接受的治疗有关。我们的研究结果呼吁在急性住院康复环境中更好地检测和管理睡眠不佳的情况。此外，如果我们的研究结果在未来得到重复，应该开展关于为医护人员、患者和家属实施安静时段以改善住院康复环境中睡眠质量的研究。
