Purpose: To report an integrative review about sleep patterns, factors that
influence sleep, and sleep interventions in acutely in hospitalized adults
; discuss methodological challenges associated with studying sleep in this
population; and propose future research.
Organizing framework: Research literature on sleep patterns of acutely ill
hospitalized adults, obtained using computerized searches of Medline and CI
NAHL, was reviewed. Studies of patients on intensive care and medical-surgi
cal units conducted in a range of health disciplines over a span of almost
30 years were included Studies were organized into the following categories
: descriptive studies of sleep using objective and subjective measures; cor
relational studies of personal, health status, and environmental variables
and sleep; and intervention studies.
Findings: Sleep disturbance is a common but highly variable experience duri
ng acute care hospitalization. Multiple personal, health status, and enviro
nmental factors are related to sleep disturbance. Behavioral interventions
show promise as a means to modify factors related to sleep. Few studies hav
e shown the outcomes of sleep disturbance in acute care settings.
Conclusions: More systematic research is needed to determine correlates of
sleep disturbance in acutely ill hospitalized adults. Such studies can help
investigators to identify patients who are most at risk for sleep disturba
nce and to provide the theoretical and conceptual bases for sleep-promoting
interventions; Methodological challenges include characteristics of acute
care patients and hospital environments, as well as the complexity of measu
ring sleep.