A new study published in the Emergency Medicine Journal has confirmed what anyone who's ever spent time in a hospital emergency department already knows: ED patients don't rest as well as inpatients.
Researchers surveyed 49 ED patients who were awaiting an inpatient bed and 44 people who had already been admitted to an inpatient unit.
During the survey, patients described noise levels and rated the quality of their sleep using the Richards-Campbell Sleep Questionnaire. That is, patients ranked their sleep quality on a 1-100 scale, with 1 being the worst and 100 the best.
Questions focused on:
- How lightly or deeply they slept;
- How easily they fell asleep;
- How often they awoke during the night;
- How easily they returned to sleep when they did wake up; and
- If they thought they had a good or bad night’s sleep.
The research team factored in patient characteristics that could affect sleep such as their age and the acuity of their illness or injury. Even after accounting for these factors, the team found patients in inpatient rooms rated their sleep environment as 65% quieter than patients in the ED.
Patients in the ED also said their sleep was significantly worse across all five aspects of sleep quality. Patients with cognitive impairments, those who were incapacitated or had used alcohol or drugs in the previous 24 hours were excluded.
“Often in my experience, patients react with dread at the idea of spending a night in the noisy ER — bad enough you are unwell, and been told you need to stay in hospital, without then having to stay in the sleepless ER for the night,” said Dr. Richard Prendiville, the lead study author and a researcher at National University of Ireland in Galway.
“Hopefully the finding will show hospitals that ER patients sleep measurably worse, and that this needs to be addressed,” Prendiville was quoted as saying in Reuters Physicians Weekly.
A key difference was the age of patients in the study. Half of those who stayed in the ED were 60 years or older. Patients given inpatient rooms had a median age of 47.
ED patients were also more gravely ill. About three quarters were identified as the most seriously ill and injured patients upon arrival. Slightly less than half of inpatients were considered to be the most seriously ill.
The study wasn't a perfect experience. First, it wasn't controlled so it couldn't prove that staying in the ED or transferring to an inpatient bed directly improved sleep or health. The study also didn't factor in the effect of pain and the use of painkillers on sleep quality.
Even so, adequate sleep is vital to people who are sick, injured or recovering from a surgery or illness.
“Insufficient sleep causes stress…which increases sleepiness during the day and may limit mobility,” Nanayakkara said. “This will cause loss of function especially in the elderly and can also cause delirium with and negatively impact general wellbeing.”
The study was conducted at the University College Hospital in Galway, Ireland, in October and November 2016.
