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Sleep in Acute Care Settings: An Integrative Review

Originally Published:
2000
Key Point Summary
Key Point Summary Author(s):
Terri Zborowsky
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Key Concepts/Context

Despite three decades of research, little is known about sleep in acute care settings. Yet, for many adults in these settings, disturbed sleep is common. This literature review looks at studies of hospitalized patients in intensive care and medical surgical units.

Objectives

This literature review examines sleep patterns, factors that influence sleep (such as environmental elements), and sleep interventions in acutely ill hospitalized adults. It also reviews the methodological challenges of studying sleep in this population and proposes future research.

Methods

The author searched Medline and CINAHL to find research literature on sleep patterns of acutely ill hospitalized adults, including studies of patients on intensive care and medical-surgical units in a variety of health disciplines over 30 years. 

Design Implications
Designers should be aware of this literature review as it includes a critique and summary of the means, methods, and tools used in studies that explore the relationship between sleep and factors that impact sleep in hospitalized patients. As designers try to design quieter healthcare environments, this study provides valuable benchmarking information.
Findings

Most people, including healthcare professionals, assume sleep is restorative and, therefore, enhancing patient’s sleep will improve outcomes. However, this assumption has not been studied all that much and is, at present, unproven.

The author notes that conducting these studies and interpreting the findings are difficult because there are so many factors that influence sleep and other outcomes. Therefore, it is difficult for researchers to design the controlled studies that would evaluate the cause and effect. However, research in this area is ongoing and could provide a basis for continued research in acute care settings.

The author organized the studies into categories: descriptive studies of sleep using objective and subjective measures; correlational studies of personal, health status, and environmental variables and sleep; and intervention studies.

Finally, the author reviewed the tools used to measure sleep in acutely ill patients, such as polysomnography (PSG), actigraphy, observation, and self-report.
 

Limitations

There are no limitations noted with this literature review.

Design Category
Acoustic Environment
Setting
Hospitals
Outcome Category
Patient / resident satisfaction and comfort
Environmental Condition Category
Patient Satisfaction and Comfort
Key Point Summary Author(s):
Terri Zborowsky
Primary Author
Redeker, N. S.