Hospitals are difficult places to sleep in, with early morning blood draws, endless beeping from electronic monitors, loud conversations, and more often keeping patients awake. To address this issue, some health experts have encouraged the idea of "sleep as medicine" to help hospitalized patients heal and recover more effectively, Katherine Ellison writes for the Washington Post.

How sleep deprivation is harming hospitalized patients

According to NIH, a lack of high-quality sleep can increase the risk of several health conditions, including heart disease, stroke, obesity, and dementia. Research has also shown an association between sleep deprivation and elevated blood sugar levels in hospitalized patients, both with and without diabetes.

"The hospital itself and its barrage of stress can become a toxic place — a place actively causing harm," said Harlan Krumholz, a cardiologist at Yale University.

Sleep deprivation can also contribute to what Krumholz calls "post-hospital syndrome," a condition in which a patient's health declines following a hospitalization. Some issues patients face after a hospitalization include a weakened immune system, a loss of body mass, and more, all of which could potentially land them right back in the hospital.

"At the time of discharge, the physiological systems are impaired, physiological reserves are depleted, and the body cannot effectively avoid or mitigate health threats," Krumholz wrote in an article for the New England Journal of Medicine.

Separately, Donald Edmondson, an associate professor of behavioral medicine at the Columbia University Irving Medical Center, has researched how different factors, including shortened sleep, may contribute to a "PTSD-like response" to hospitalization.

"We can turn the dial up or down as to how traumatic an experience may be through these hospital factors," Edmondson said.

According to Krumholz, the "almost military mentality" in most hospitals likely contributes to the sleep deprivation many patients face. "The idea is everyone has to tough it out," he said. "But this is different than just patient satisfaction and customer care. People are getting sick and some are surely dying because of this."

How can hospitals help patients get better sleep?

According to a study published in August, fewer than half of hospitals have sleep-friendly practices, such as adjusting lab and medication schedules, reducing overnight vitals monitoring, or implementing "quiet hours."

Nancy Foster, VP for quality and patient safety at the American Hospital Association, said that while experts' arguments about poor sleep leading to poor health outcomes were "interesting and certainly an issue where clinicians are going to have to weigh the pros and cons," the organization had not highlighted the problem among its members due to a lack of evidence that one caused another.

"For most clinicians to act we have to show that action A results in outcome B," Foster said.

Nevertheless, researchers, as well as some professional organizations, are encouraging providers and hospitals to do more to help improve patients' sleeping habits while hospitalized.

Both the Society of Hospital Medicine and the American Academy of Nursing recommend that hospitalized patients not be woken up unnecessarily. Separately, Vineet Arora, the dean for medical education at the University of Chicago Biological Sciences Division, and Nicola Orlov, published an article in Sleep that called for a "sleep-friendly" designation to incentivize hospitals to adjust their policies.

Arora has also suggested changes at UChicago Medicine to help improve patients' sleep, including prolonging blood draws to every 48 instead of 24 hours and scheduling at later times to allow patients to get more sleep.

In a thread on Twitter, Krumholz described "sleep as medicine," saying that he strongly believed that it is "essential to recovery from acute illness."

"We need to put people in a position to help their bodies heal and [recover]… not make it more difficult," he said. (Ellison, Washington Post, 2/19)