Quantifying Sleep-Wake Rhythms in the Hospital Environment with Digital Technologies.

Area of Science:

• Circadian biology
• Sleep medicine
• Postoperative care

Background:

• Postoperative clinical care environments often disrupt patients' natural circadian rhythms.
• This circadian desynchronization may negatively impact patient health outcomes and recovery.

Purpose of the Study:

• To quantify environmental disruptors in postoperative care settings.
• To assess the impact of these disruptions on patient's behavioral-physiological rhythms and cognitive function.

Main Methods:

• Collected 1.8 million data points using 11 remote sensors from 13 cardiac surgery patients.
• Monitored preoperative, in-hospital, and post-discharge settings.
• Assessed environmental factors (light, sound, temperature), physiological rhythms (heart rate variability), and cognitive function.

Main Results:

• Hospital environments exhibited frequent nighttime activity, excessive noise, and inadequate temperature regulation.
• Significant disruption and phase-shifting of behavioral-physiological rhythms were observed, including increased nighttime wakefulness (10.7% to 34.8%).
• Cognitive function scores decreased, with 31% of patients experiencing transient mild impairment.

Conclusions:

• Postoperative care environments present significant circadian and diurnal disruptors.
• These disruptions are associated with impaired physiological rhythms and cognitive function.
• Findings support the need for interventions to mitigate environmental disruptors and improve patient outcomes.