Quality of sleep in the medical department

The quality of sleep in 134 patients admitted to two medical departments and an intensive coronary care unit was studied by comparing pre- and post-admission sleeping scores. Four aspects of sleep have been evaluated: duration of sleep; number of awakenings; personal assessment of quality of sleep; and the need for using sleeping pills. Results were expressed in scores ranging from 1 (worst) to 4 (best). A significant reduction in the mean quality of sleep for the entire group was found for all scores employed (P<0.01-P<0.001). Of the 134 patients, 51% had a reduction in post-admission total sleep score (23 ± 3%, mean ± SE); 31% had no change or mixed trends in the various scores, with a change in total sleep score not exceeding 3 ± 3%; and 18% had an improved total sleep score (16 ± 2%). Of the individual scores, a deterioration was found in the following order of frequency: number of awakenings (37%); personal assessment of quality of sleep (32%); duration of sleep (31%); and the need for using sleeping pills (26%). Of the reasons specified for impaired quality of sleep, the most important were noise made by other patients or by the medical staff (47%), and the patient's own disease (30%). Significant differences in the quality of sleep between the two medical departments located in different hospitals have been encountered (P<0.01). In the department with a greater impairment in sleep score, about twice as many patients were housed per room as in the other department and complaints about noise made by other patients were significantly more common (P<0.05). These findings indicate that the quality of sleep is impaired by hospital admission in the majority of patients and this is attributed mainly to environmental factors. Our findings suggest that increased awareness of the patient's needs for rest and privacy on the part of hospital staff and planners may result in significant improvement in the quality of sleep.