Sleep Disturbance in Older Patients in the Emergency Department: Prevalence, Predictors and Associated Outcomes

Helen Mannion, D. William Molloy and Rónán O’Caoimh
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Helen Mannion: Clinical Sciences Institute, National University of Ireland, H91 TK33 Galway City, Ireland
D. William Molloy: Centre for Gerontology and rehabilitation, University College Cork, St Finbarr’s Hospital, T12 XH60 Cork City, Ireland
Rónán O’Caoimh: Clinical Sciences Institute, National University of Ireland, H91 TK33 Galway City, Ireland

IJERPH, 2019, vol. 16, issue 19, 1-12

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.

Keywords: sleep; emergency department; hospital; length of stay; frailty (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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