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Jul 2016

A Z-z-z-z Way to Get Well at the Hospital

Sometimes the best medicine is right over our eyes. The simple prescription? Our eyelids.

I grew up listening to a host of Italian relatives always telling me, “Sleep is the best medicine.” Of course, the old country treatment for ailments has always been espoused by personal physicians as well.

However, when it comes to implementing this no-brainer medicine, hospitals have been lagging for decades as technology launched the patient into a world of electronic beeps and bright lights from monitors to hallways. Luckily, according to a USA Today article, it appears this change is part of a growing national recognition among hospitals that sleep plays a critical role in the healing process.

Hospitals traditionally were designed around the health provider’s need to gather as much health information as possible and check in on patients, often based upon the physician’s or nurse’s schedule.

Ever try to sleep in a hospital bedroom without an Ambien? I spent a total of eight nights in my wife’s hospital room for the birth of our two children. I wager, I tallied a grand total of eight hours of solid sleep and I was the healthy person, and we had a private room.

Patients without sleep resemble my teenage son after a long night of binge-watching his favorite TV show: cranky. Lack of sleep can slow recovery and trigger the confusion of delirium. These medical setbacks can lead to longer hospital stays for a patient and possibly dementia, in extreme cases.

Technology, often the cause of sleeplessness, is now lending improvements to patient care. Hospital nurses may now watch patients from their nursing stations instead of entering patient rooms to constantly check in on the patient.  Implementing this change to prioritize sleep for a patient; however, is far easier said than done.

“It’s a lot easier to deliver health care with the lights on and when you’re physically in a patient’s room,” Dana Edelson, an assistant professor of medicine at University of Chicago Medicine, told the USA Today.

Hospital workflow often means that many scans and blood work have been done at night. This downtime is when the technicians have time to catch up with their workload to ensure the patient’s results are ready before doctors make their 6 a.m. rounds at the hospital.

Theresa Kirkpatrick, a clinical nurse specialist at Mattel Children’s Hospital UCLA in Los Angeles, helped lead her provider’s effort to prioritize sleep in the pediatric intensive care unit. Today, Mattel Children’s nurses weigh babies before bedtime. Furthermore, physicians come in quietly at 6 a.m. to do quick patient assessments, waiting until later in the day for a more thorough exam. This approach has proven to be crucial for teenage patients recovering in a hospital bed.

Since the Mattel program began late in 2015, Kirkpatrick noted that the patients need less medicine at night, babies’ schedules are less mixed up between day and night, and the alarms that do go off are actually meaningful rather than just a pain, pardon the pun.

The Pro-Sleep focus at hospitals has made a major difference for patient families, as well as the sick or infirm. When young patients and their families are exhausted, it is difficult for them to try their hardest at therapy, as well as keeping a chipper attitude through all that needs to be done at a hospital. Parents can now be more creative, supportive partners when they are not awakened every hour for weeks at a time.

Research has shown that hospital lighting also interferes with a patient’s body clock. Bright lights at night prevent patients from unwinding and falling into a deep REM sleep. In addition, too little daylight in the morning interferes with the patient’s ability to reset their clocks and feel alert.

Of course, my relatives also said that too much of a good thing might not be very healthy.  Healthcare critics will worry that the pendulum will swing too far and hospitals will feel the need to prescribe lots of sleep medications, just as physicians did this century when they turned to pain medications when a patient’s pain becomes a prominent public issue.

The next logical step in this data-driven time will be the hospital with a personalized look at the costs and benefits of waking patients up versus letting them sleep. While hospitals will never resemble the finest five-star spa or resort near you, the changes are at least heading down the right path.


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