Patient-reported sleep and physical function during and after hospitalization.

Area of Science:

• Gerontology
• Sleep Medicine
• Rehabilitation Medicine

Background:

• Poor sleep is linked to community morbidity and mortality.
• The impact of poor sleep during and after hospitalization is not well understood.

Purpose of the Study:

• To describe trends in patient-reported sleep and physical function during and after hospitalization.
• To evaluate sleep as a predictor of post-discharge function.

Main Methods:

• Secondary analysis of trial data from 232 adults followed for 3 months post-discharge.
• Patient-reported sleep (Pittsburgh Sleep Quality Index) and physical function (Katz ADL, Lawton IADL, Nagi Mobility Scale) were assessed during hospitalization and at 1, 5, 9, and 13 weeks post-discharge.

Main Results:

• Sleep quality significantly declined during hospitalization and remained poor for 3 months post-discharge (p < .001).
• Mobility and instrumental activities of daily living also declined significantly post-hospitalization (p < .001).
• Each 1-point increase in Pittsburgh Sleep Quality Index score predicted a 1.48-fold increase in odds of mobility impairment (95% CI 1.27-1.71, p < .001).

Conclusions:

• Patient-reported sleep worsens during hospitalization and does not significantly improve for 3 months post-discharge.
• Poor sleep is a significant predictor of functional impairment during the post-discharge period.
• Sleep dysfunction originating during hospitalization may impede functional recovery.