BOSTON — Sleep disruptions are common at VHA subacute rehabilitation facilities, according to a new study recommending the examination of environmental factors.
The authors from the VA Boston Healthcare System and Harvard Medical School also suggested that insomnia symptoms be evaluated at admission and discharge in a subacute rehabilitation care setting.
The study in Clinical Gerontologist focused on veterans age 50 and older who were admitted to a VHA subacute rehabilitation between March and August 2022. Baseline assessments were completed by 46 patients, with follow-up assessments from 33, using Insomnia Severity Index (ISI), Sleep Need Questionnaire (SNQ) and Epworth Sleepiness Scale (ESS). The researchers also performed an assessment of environmental sleep disruptors.1
“Veterans were offered sleep resources after admission evaluations and outpatient referrals after discharge evaluations,” the authors noted, adding that Pearson correlation determined associations between length of stay (LOS), ISI, SNQ and ESS scores at admission and discharge; chi-square and Wilcoxon Signed Rank Tests compared insomnia at admission and discharge.
Their results indicated that one-half of participants reported clinically meaningful insomnia symptoms and sleep needs at baseline, with no significant change at discharge. “Almost all (89.1%) veterans reported sleep was disturbed by environmental factors, primarily staff awakenings,” the study team advised. “LOS was correlated with ESS scores at discharge (r = .52, p = .002).”
The study concluded, “Environmental sleep disruption was common during a subacute rehabilitation admission and were not adequately addressed through sleep resources and treatment due to low uptake.”
In addition to assessing sleep at admission, providers should lessen “environmental sleep disruptors by reducing noise, light, and non-essential awakenings at night,” the researchers recommended.
- Boyle JT, Boeve AR, Moye JA, Driver JA, Ruopp M, O’Malley K. Insomnia Symptoms and Environmental Disruptors: A Preliminary Evaluation of Veterans in a Subacute Rehabilitation. Clin Gerontol. 2024 Feb 6:1-13. doi: 10.1080/07317115.2024.2313494. Epub ahead of print. PMID: 38320999.