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New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate.

Authors
  • Ho, An1
  • Raja, Bronson1
  • Waldhorn, Richard2
  • Baez, Valentina1
  • Mohammed, Idiris1
  • 1 Medicine Department, Medstar Harbor Hospital, Baltimore, MD, USA.
  • 2 Pulmonary and Critical Care Department, Medstar Georgetown University Hospital, Washington, DC, USA.
Type
Published Article
Journal
Journal of Community Hospital Internal Medicine Perspectives
Publisher
Informa UK (Taylor & Francis)
Publication Date
Jan 01, 2017
Volume
7
Issue
5
Pages
309–313
Identifiers
DOI: 10.1080/20009666.2017.1374108
PMID: 29147474
Source
Medline
Keywords
License
Unknown

Abstract

Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors from day 3 to day 5 of their hospital stay. We excluded patients with a prior insomnia history. Results: Out of the 205 patients who met the inclusion criteria, 75 patients (36%) reported insomnia. Severe insomnia was present in 3% of patients. Difficulty in maintaining sleep is the most common symptom. Frequent staff disruptions due to blood draws and vital signs checks were reported by 68% as the cause of insomnia, followed by illness associated causes (64%) and sleep disruption due to noise and or brightness (23%). Patients with insomnia had more awakenings due to noise, brightness, and staff interruptions than those without insomnia (1.35 times vs. 0.9 times, p = 0.027). Patients with respiratory symptoms, cardiac monitoring, oxygen use, private rooms, and no sedative use did not have a higher insomnia risk. Patients with insomnia had significant lower satisfaction scores than patients without insomnia (4.53 vs. 4.05, p = 0.001) but did not have a different length of stay (6.18 vs. 6.19, p = 0.97). In 31% of patients with insomnia who were able to be contacted two weeks after discharge, 75% of them had insomnia resolution. Conclusion: New onset of insomnia occurred in 36% of hospitalized patients. Most common causes are staff disruption and disease symptoms. It was usually short-term and could decrease patients' satisfaction score.

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