Christine M. Willinger MD, MPH , Kimberly J. Waddell PhD, MSCI , Vineet Arora MD, MPP , Mitesh S. Patel MD, MBA , S. Ryan Greysen MD, MHS
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Main measures were patient-reported surveys on sleep (Pittsburgh Sleep Quality Index) and physical function (Katz </span>Activities of Daily Living<span><span>, Lawton Instrumental Activities of Daily Living, and </span>Nagi Mobility Scale) were collected during hospitalization and at 1, 5, 9, and 13</span></span> <!-->weeks postdischarge.</p></div><div><h3>Results</h3><p>Patient-reported sleep declined significantly during hospitalization and remained worse for 3<!--> <span>months postdischarge (median Pittsburgh Sleep Quality Index</span> <!-->=<!--> <!-->8 vs. 6, <em>p</em> < .001). In parallel, mobility declined significantly from baseline and remained worse at each follow-up time (median Nagi score<!--> <!-->=<!--> <!-->2 vs. 0, <em>p</em><span> < .001). Instrumental activities of daily living similarly decreased during and after hospitalization, but basic activities of daily living were unaffected. In adjusted time-series logistic regression<span> models, the odds of mobility impairment were 1.48 times higher for each 1-point increase in Pittsburgh Sleep Quality Index score over time (95% CI 1.27-1.71, </span></span><em>p</em> < .001).</p></div><div><h3>Conclusions</h3><p>Patient-reported sleep worsened during hospitalization, did not improve significantly for 3<!--> <span>months after hospitalization, and poor sleep was a significant predictor of functional impairment over this time. Sleep dysfunction that begins with hospitalization may persist and prevent functional recovery after discharge.</span></p></div><div><h3>Trial registration</h3><p>The primary study was registered at ClinicalTrials.gov NCT03321279.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patient-reported sleep and physical function during and after hospitalization\",\"authors\":\"Christine M. Willinger MD, MPH , Kimberly J. Waddell PhD, MSCI , Vineet Arora MD, MPP , Mitesh S. Patel MD, MBA , S. Ryan Greysen MD, MHS\",\"doi\":\"10.1016/j.sleh.2023.12.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>Poor sleep is associated with morbidity and mortality in the community; however, the health impact of poor sleep during and after hospitalization is poorly characterized. Our purpose was to describe trends in patient-reported sleep and physical function during and after hospitalization and evaluate sleep as a predictor of function after discharge.</p></div><div><h3>Methods</h3><p>This is a secondary analysis of trial data with 232 adults followed for 3<!--> <span><span>months after hospital discharge. 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In adjusted time-series logistic regression<span> models, the odds of mobility impairment were 1.48 times higher for each 1-point increase in Pittsburgh Sleep Quality Index score over time (95% CI 1.27-1.71, </span></span><em>p</em> < .001).</p></div><div><h3>Conclusions</h3><p>Patient-reported sleep worsened during hospitalization, did not improve significantly for 3<!--> <span>months after hospitalization, and poor sleep was a significant predictor of functional impairment over this time. Sleep dysfunction that begins with hospitalization may persist and prevent functional recovery after discharge.</span></p></div><div><h3>Trial registration</h3><p>The primary study was registered at ClinicalTrials.gov NCT03321279.</p></div>\",\"PeriodicalId\":48545,\"journal\":{\"name\":\"Sleep Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352721823003017\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352721823003017","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：睡眠质量差与社区中的发病率和死亡率有关；然而，睡眠质量差在住院期间和住院后对健康的影响却鲜为人知。我们的目的是描述住院期间和住院后患者报告的睡眠和身体功能的变化趋势，并评估睡眠对出院后身体功能的预测作用：这是对 232 名成人出院后随访 3 个月的试验数据进行的二次分析。主要测量指标是患者报告的睡眠调查（匹兹堡睡眠质量指数）和身体功能调查（卡茨日常生活活动、劳顿器械性日常生活活动和纳吉行动能力量表），分别在住院期间和出院后1、5、9和13周进行：结果：住院期间，患者报告的睡眠质量明显下降，出院后3个月的睡眠质量仍然较差（匹兹堡睡眠质量指数中位数=8 vs. 6，P 结论：患者报告的睡眠质量下降，出院后3个月的睡眠质量仍然较差（匹兹堡睡眠质量指数中位数=8 vs. 6，P 结论）：患者报告的睡眠情况在住院期间恶化，在住院后的 3 个月内没有明显改善，睡眠质量差是在此期间功能受损的重要预测因素。住院期间开始出现的睡眠功能障碍可能会持续存在，并阻碍出院后的功能恢复：主要研究已在 ClinicalTrials.gov NCT03321279 上注册。
Patient-reported sleep and physical function during and after hospitalization
Purpose
Poor sleep is associated with morbidity and mortality in the community; however, the health impact of poor sleep during and after hospitalization is poorly characterized. Our purpose was to describe trends in patient-reported sleep and physical function during and after hospitalization and evaluate sleep as a predictor of function after discharge.
Methods
This is a secondary analysis of trial data with 232 adults followed for 3 months after hospital discharge. Main measures were patient-reported surveys on sleep (Pittsburgh Sleep Quality Index) and physical function (Katz Activities of Daily Living, Lawton Instrumental Activities of Daily Living, and Nagi Mobility Scale) were collected during hospitalization and at 1, 5, 9, and 13 weeks postdischarge.
Results
Patient-reported sleep declined significantly during hospitalization and remained worse for 3 months postdischarge (median Pittsburgh Sleep Quality Index = 8 vs. 6, p < .001). In parallel, mobility declined significantly from baseline and remained worse at each follow-up time (median Nagi score = 2 vs. 0, p < .001). Instrumental activities of daily living similarly decreased during and after hospitalization, but basic activities of daily living were unaffected. In adjusted time-series logistic regression models, the odds of mobility impairment were 1.48 times higher for each 1-point increase in Pittsburgh Sleep Quality Index score over time (95% CI 1.27-1.71, p < .001).
Conclusions
Patient-reported sleep worsened during hospitalization, did not improve significantly for 3 months after hospitalization, and poor sleep was a significant predictor of functional impairment over this time. Sleep dysfunction that begins with hospitalization may persist and prevent functional recovery after discharge.
Trial registration
The primary study was registered at ClinicalTrials.gov NCT03321279.
期刊介绍：
Sleep Health Journal of the National Sleep Foundation is a multidisciplinary journal that explores sleep''s role in population health and elucidates the social science perspective on sleep and health. Aligned with the National Sleep Foundation''s global authoritative, evidence-based voice for sleep health, the journal serves as the foremost publication for manuscripts that advance the sleep health of all members of society.The scope of the journal extends across diverse sleep-related fields, including anthropology, education, health services research, human development, international health, law, mental health, nursing, nutrition, psychology, public health, public policy, fatigue management, transportation, social work, and sociology. The journal welcomes original research articles, review articles, brief reports, special articles, letters to the editor, editorials, and commentaries.
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