Sleep quality in an acute inpatient rehabilitation setting: the importance of prior sleep disorders

Research Objectives: To assess whether demographic and clinical factors might impact sleep quality during inpatient stay in a rehabilitation setting.

Design: In this prospective study, patients were assessed for their sleep quality at admission and discharge.

Setting: Patients admitted in the acute inpatient rehabilitation unit of Casa Colina Hospital and Centers for Healthcare (Pomona, California) were included in the study.

Participants: Thirty five patients participated to this study (age=61±16 years old; BMI=30±7kg/m2; 18 females, 18 Caucasians).

Interventions: None

Main Outcome Measures: The Pittsburg Sleep Quality Index (PSQI) was administered as primary outcome. Demographic and clinical data were collected as covariates (i.e., age, BMI, gender, race, cause of hospitalization, pre-hospital setting and prior diagnosis of sleep disorders). The level of anxiety and depression were also assessed using Beck Anxiety Inventory (BAI) and Patient Health Questionnaire-9 (PHQ-9).

Results: The average length of hospitalization was 18±8 days. Cause of hospitalization included stroke (20%), spinal cord injury (28%), orthopedic (28%) and other diagnosis (23%). In this sample, 22% had a sleep disorder diagnosis (mostly sleep apnea) and 60% came from an acute care unit. ANOVAs with repeated measures were performed on the outcome measure (PSQI) controlling for BMI and age. Among the demographic and clinical variables considered, the presence of sleep disorders had an effect on changes in PSQI total scores. The PSQI decreased significantly in patients with prior diagnosis of sleep disorders. The pre-hospital setting trended toward statistical significance only for the group without sleep disorders. The initial level of anxiety or depression did not have an effect on the PSQI scores. However, changes in BAI and PHQ-9 total scores were related to changes in PSQI. Finally, our dataset did not reveal an effect of race or gender.

Conclusions: Prior sleep disorders diagnoses factors has an impact on sleep quality during hospitalization. These results identify high-risk patient characteristics that impact sleep hygiene which will be taken into consideration in developing an intervention for improving inpatient sleep hygiene.

Author(s) Disclosures: The authors have nothing to declare.