Sleep in The Hospital: Educating Our Healthcare Partners
What is our role when it comes to educating our healthcare partners?
“It’s only sleep.”
“They use CPAP at home, but we didn’t set them up here.”
“Sleep? It’s a hospital! Nobody can sleep.”
“Mrs. Smith, we need to give you a sleeping pill. It’s in your orders, so wake up.”
We need to educate our fellow healthcare workers about the need to let patients sleep in the hospital. It appears that many folks are still unaware of, or underestimate, the role of sleep in the healing process. This is not their fault.
This is not uncommon, as I was just as unfamiliar years ago about the beneficial impact of sleep.
In fact, a large population of physicians is not aware of how important sleep is, and what healing processes are occurring during this third of our life.
This should be no surprise since physicians only receive about 4 hours total training about sleep issues during their medical career! How many physicians ask about sleep during a routine physical? And if they do ask, they often just hand out a sleeping pill rather than finding out what the issue is. But now that I am a sleep professional I believe it is my obligation to help foster sleep awareness among our hospital staff.
Sleep helps to promote healing, primes the immune system, results in fewer hospital falls and in less dependence on sedatives.
We should try to help patients to preserve good sleep hygiene while they are patients here. I heard about a patient who was disturbed to have been woken up at 9:30 PM for some trivial information needed in his electronic health record that could have waited. Instead of listening to the patient and being glad this patient was trying to observe good sleep hygiene; the caregiver informed him that staff collects information until 10 PM! This is wrong!
The patient that did not want to be awakened at 9:30 PM should be commended for trying to protect his sleep. Perhaps we should ask folks what time they normally go to sleep so we can care for them in an efficient way that respects their sleep needs, as well as meets our needs.
These are the types of changes that will lead to both better healing and better scores on hospital ratings.
As far as the patients and/or staff that state “Oh well-it is a hospital- it is going to be noisy”, I believe that as health professionals we must not allow that to be the accepted “truth”. We should educate both staff and patients that healing is compromised, cardiac systems are taxed, stress hormones are elevated, and there is an increased chance for hospital acquired infections. These are factors to be considered and addressed via assuring the patient adequate sleep. This is one of the reasons we recently starting asking our inpatients about their rest.
Actually, as medical staff, we should also be addressing any sleep issues we see in our hospitalized patients (pauses in breathing) or hear (loud snoring) in the patient’s discharge plan by suggesting they see a sleep specialist. Undiagnosed or untreated sleep issues lead to and are often connected with diabetes, hypertension, stroke, and car accidents.
This past week we treated a man that stopped breathing184 times per hour! How many years was this man driving amongst us in a sleep deprived state?
How many times was this walking zombie in different hospitals where his loud snoring was not recognized as a health issue and addressed by medical staff as part of his discharge plan?
Sleep is not a passive waste of time! It is an active and vital process.
According to a 2013 study published in JAMA Internal Medicine waking those patients may contribute to bad patient results and dissatisfaction, and could also increase the odds of patients having to come back to the hospital. I also suggest this article for further information.
If we wish to change the culture in our hospitals and increase awareness of the importance of sleep we must start by making sure, as health professionals, that all of us are on board and understand this is not just about noise, and hospital ratings but also about helping our patients to heal and maintaining health.
As part of the sleep medicine team, I feel it is important to advocate for sleep, and make a difference for our hospitalized patients.
As we in sleep medicine have seen proper rest can make a big difference for our patients both physically and mentally.
Some hospital medical staff will read this and “get it”. Others will continue to trivialize sleep as not important. But at least I have made an attempt to bring folks up to speed on what science has proven; the healing power of sleep. I believe all of us in sleep medicine have an obligation to educate staff we encounter that do not understand the power of sleep as a major healing force.