Sleep Disorders |

Sleep Quality in Patients Admitted to the General Medical Floors FREE TO VIEW

Mandeep Grewal; Sandeep Khosa; Dennis Auckley
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Internal Medicine, MetroHealth Medical Center, Cleveland, OH

Chest. 2014;146(4_MeetingAbstracts):952A. doi:10.1378/chest.1993670
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: In hospitalized patients, sleep deprivation potentially leads to negative outcomes. Sleep deprivation results from multiple factors related to the inpatient setting. We sought to objectively study sleep in those admitted to the general medical floors at our institution and examine potential factors associated with poor sleep.

METHODS: A prospective observational study was performed. Direct admissions to the general medical floors were randomly approached to participate in the study. Eligible patients underwent attended polysomnography (PSG) in their hospital room within 48 hours of admission. The PSGs were scored for sleep architecture, and demographic/medical data were abstracted from the patient’s record. Comparisons were made between patients whose sleep efficiency was in the lowest (≤50%) and highest 3rd (≥69%) using Student’s T-test and Fischer Exact where appropriate.

RESULTS: 62 patients had adequate PSG data and documentation to be included. Demographics: average age 47.0+/- 12.9 years old, gender 59.7% female, ethnicity 48.5% Caucasian, 43.5% African American. Admitting diagnosis: respiratory 41.9%, infectious disease 19.4%, GI 17.7%, neurologic 11.3%, miscellaneous 9.7%. 66.1% of patients received opioids and 9.7% received benzodiazepines. Sleep architecture: TST 212.2 +/- 77.8 minutes (range 32-392), SL 58.0 +/- 62.3 minutes (range 0.1-304), WASO 96.8 +/- 57.7 minutes (range 4-287), SE 57.6 +/- 20.8 minutes (range 11.6-94.8), SWS% 7.6 +/- 13% (range 0-65.1), REM% 15.1+/- 10.4% (range 0-51.1). The number of disruptions per night averaged 2.6 +/- 1.8. Causes of disruptions: nursing assessments, alarms, blood draws, respiratory treatments, care of the patient’s hospital roommate. Comparing those with ≤50% SE to those with ≥ 69%, male gender (p=0.01) and an admitting diagnosis of acute respiratory disease (p=0.07) were associated with poor SE. Age, ethnicity, opioids/benzodiazepines and number of disruptions were not significantly associated.

CONCLUSIONS: Sleep in patient’s admitted to the general medical floor is poor.

CLINICAL IMPLICATIONS: While many factors may be associated with this, data from this pilot study suggested only male gender and a respiratory admitting diagnosis were associated. Further study is needed to evaluate this problem in the hospital setting.

DISCLOSURE: The following authors have nothing to disclose: Mandeep Grewal, Sandeep Khosa, Dennis Auckley

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