Not every patient has difficulty sleeping in an acute care setting, but it is common. Environmental factors, such as light and noise, can interfere with sleep, further compromising an existing sleep problem. Environmental light, considered a primary cue for setting the internal clock and maintaining normal day/night rhythms, is often different in acute care settings compared to home and may affect sleep. However, there is not much research on the effect of light on sleep. In several studies, noise was the most common environmental cause of sleep disturbance in hospitals and nursing homes.
This pilot study describes the characteristics of older adults’ sleep in acute care environments and measures noise and light levels to see how they affect sleep.
The sound level did not differ between participants in private versus semiprivate rooms, nor with number of comorbidities. The primary sources of noise in the participants’ rooms appeared to be the automatic alternating pressure mattress and the air conditioning system.
Light levels followed a day–night rhythm, with consistent dimming of lights at night and brightening in the early morning. The average lights-out time did not reflect onset of sleep time per actigraph readings. The first sleep period usually occurred about 30 minutes after the lights dimmed, but sleep periods were often short and interrupted by wakefulness. The major sleep period happened several hours after the lights dimmed. None of the participants received hypnotic or sedative medications, and none had dementia or consumed alcohol.
Because patients were discharged, data were available for fewer participants on the second and third nights, so it is possible that data were skewed by the increased severity of illness of participants with prolonged hospitalization. It is difficult to compare these levels of light with usual room light levels, as there is no standard for luminance from particular lightbulb wattage.
Reviewer note: Small sample size means generalizability is limited.