Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
Which Factors Affect Sleep Efficacy Among Long-Term Hospitalized Older Patients in Rehabilitation Ward? Continuous 14-Day Monitoring Using Non-Wearable Devices
19 Pages Posted: 24 Jun 2020
More...Abstract
Background: Although older people, particularly those with health problems, often experience poor sleep, few studies have examined sleep efficacy in this population. In addition, there have been few efforts to measure how daily fluctuations in individual and environmental characteristics affect sleep efficacy.
Methods: In this cross-sectional study, we used non-wearable actigraphy to measure the effect of demographic, environmental, and daily clinical factors on sleep efficacy over 14 days. Participants were older inpatients, some of who had communication difficulties, receiving rehabilitation in a hospital in Japan. Illumination levels, noise, excretion, and patient subjective mood and stress were measured daily. Sleep data were collected using a sleep monitor attached to the patient’s bed. Multiple regression analysis was used to identify predictors of sleep efficacy.
Findings: Analysis was conducted for 1008 records from 76 participants. Older age, being female, regularly taking sleep medication, frequent nighttime urination, and being post-stroke were significant predictors of poor sleep efficacy. Environmental factors did not affect sleep efficacy. Newly admitted patients reported better sleep efficacy (age, β=-0･38, p<0･001; sex [female], β=-0･17, p<0･05; new hospitalization [no], β=--0･30, p<0･001; main ICD-10 disease [stroke], β=-0･26, p<0･001; regular sleeping pill prescription [no] β=0･28, p<0･001; frequency of nocturnal urination, β=-0･24, p<0･01).
Interpretation: The findings indicate the importance of managing nighttime urination and sleep medication to improve sleep efficacy. Non-wearable sleep devices are useful in measuring sleep-related factors in older hospitalized patients and can be used by patients who have difficulty communicating. This type of sleep measurement technology may be useful in geriatric and rehabilitative care to monitor and manage sleep quality.
Funding Statement: This study was supported by Daikin Industries, Ltd, Japan.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: This study was approved by the clinical research ethics committee of Osaka University Hospital, to which the authors belongs (approval number 1741110).
Keywords: sleep monitor; environmental factors; daily clinical factors; rehabilitation ward; nonwearable device
Suggested Citation: Suggested Citation