Sleep disturbance in older patients in the emergency department: prevalence, predictors and associated outcomes
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Published version
Date
2019-09-25
Authors
Mannion, Helen
Molloy, D. William
O'Caoimh, Rónán
Journal Title
Journal ISSN
Volume Title
Publisher
MDPI AG
Published Version
Abstract
Impaired sleep is common in hospital. Despite this, little is known about sleep disturbance among older adults attending Emergency Departments (ED), particularly overnight-boarders, those admitted but housed overnight while awaiting a bed. Consecutive, medically-stable patients aged ≥70, admitted through a university hospital ED were evaluated for overnight sleep quality (Richards Campbell Sleep Questionnaire/RCSQ) and baseline sleep (Pittsburgh Sleep Quality Index/PSQI). Additional variables included frailty, functional and cognitive status, trolley location, time in ED and night-time noise levels. Over four-weeks, 152 patients, mean age 80 (± 6.8) years were included; 61% were male. Most (68%) were ED boarders (n = 104) and 43% were frail. The majority (72%) reported impaired sleep quality at baseline (PSQI ≥ 5) and 13% (20/152) had clinical insomnia. The median time spent in ED for boarders was 23 h (Interquartile ± 13). After adjusting for confounders, median RCSQ scores were significantly poorer for ED boarders compared with non-boarders: 22 (± 45) versus 71 (± 34), respectively, (p = 0.003). There was no significant difference in one-year mortality (p = 0.08) length of stay (LOS) (p = 0.84), 30-day (p = 0.73) or 90-day (p = 0.64) readmission rates between boarders and non-boarders. Sleep disturbance is highly prevalent among older adults admitted through ED. ED boarders experienced significantly poorer sleep, without this impacting upon mortality, LOS or re-admission rates.
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Keywords
Sleep , Emergency department , Hospital , Length of stay , Frailty
Citation
Mannion, H., Molloy, D. W. and O’Caoimh, R. (2019) 'Sleep Disturbance in Older Patients in the Emergency Department: Prevalence, Predictors and Associated Outcomes', International Journal of Environmental Research and Public Health, 16(19), 3577. (12pp.) DOI: 10.3390/ijerph16193577