Sleep Quality in Adult Hospitalized Patients With Infection: An Observational Study

Background: Sleep deprivation may adversely affect host defenses against infection while infection may impact sleep. We studied sleep quality in hospitalized patients with infection-related diagnoses. Methods: This was an observational study in a 900-bed tertiary care community teaching hospital involving consecutive patients seen by an infectious disease consultant from June 26, 2008 to December 31, 2011. During routine part of their care, patients were enquired about their sleep quality, categorized into either "sound" or "unsound" sleep and the reason (s) for experiencing unsound sleep. Results: Of 1,238 unique patients (mean age, 59 years), 592 (47.8%) reported unsound sleep. Patients of 50 years or younger were more likely to report unsound sleep compared with those in the age groups of 50 to 79 years (57.1% versus 45.7%) and 80 years or older (57.1% versus 36.5%) (OR: 1.58 [95% CI: 1.23-2.0] and OR: 2.32 [95% CI: 1.59-3.38], respectively). Skin and soft tissue infections, central nervous system infections, osteomyelitis/diskitis and the head and neck infections were associated with >= 50% rates of unsound sleep. Staff disruptions, pain and anxiety were the most commonly cited reasons for unsound sleep (28.9%, 26.4% and 9.6%, respectively). Patients receiving sedating and/or hypnotic medications were no more likely to report sound sleep, compared with those not receiving such medications (50.7% versus 58.7%, respectively, OR: 0.71 [95% CI: 0.5-1.00]). Conclusions: Self-reported unsound sleep is common among hospitalized patients with an infection-related diagnosis, is associated with less advanced age and is often attributed to staff disruptions, pain and/or anxiety. Interventions at improving sleep quality in this patient population seem warranted.