The Influence of Hospitalization and Nursing Interventions on Inpatients' Sleep Quality: A Multicenter Observational Study

Abstract

BACKGROUND: Sleep quality is a critical component of health and recovery, yet it remains a significant challenge during hospitalization. Poor sleep among inpatients is common and worsens throughout hospital stays, adversely affecting health outcomes and patient wellbeing. Despite its importance, sleep often receives limited attention within hospital policies and nursing practices. AIM: To evaluate the impact of hospitalization and night-time nursing interventions on the sleep quality of noncritical patients in Spanish public hospitals. METHODS: An observational, multicenter study was conducted across 12 public hospitals. Data were collected from patients admitted to surgical and medical units between January 2020 and February 2022. Sleep quality was assessed using the Pittsburgh Sleep Quality Index at hospital admission and discharge. Night-time nursing interventions (including medication administration, vital signs monitoring, blood sample collection, and anxiety management interventions), sociodemographic, anthropometric, clinical variables, and self-reported disturbances were also recorded. Statistical analyses included descriptive statistics and linear regression models adjusted for potential confounding factors. RESULTS: The study included 383 patients. Most patients (71%) presented poor sleep quality upon admission, which worsened during hospitalization (85.9%). A significant association was found between the number of intervention days and poorer sleep quality. Collection of blood samples was significantly associated with worsened sleep quality in female patients, while anxiety management was associated with lower sleep quality in males. Discomfort with roommates and night-time nursing interventions were also related to worse sleep quality. LINKING EVIDENCE TO ACTION: Hospitalization exacerbates poor sleep quality in noncritical patients. Night-time nursing interventions, discomfort with the hospital environment, and anxiety management are key factors. Interventions addressing these modifiable factors could improve patients' sleep quality and recovery. Hospital policies should incorporate sleep as a key quality indicator, promoting strategies to reduce unnecessary night-time interventions and environmental disturbances. Nursing education must emphasize sleep-friendly care practices and appropriate planning of night-time activities.