Getting a good nights sleep whilst you are in hospital is an essential part of your recovery process. Poor sleep patterns (referred to as sleep hygiene) can effect the functioning of your immune system, lead to mood disorders, effect your decision making, and increase the risk of delirium (acute confusion) in some people.

Despite this importance, hospitals are usually poor sleep environments. There are constant interruptions, frequent noises, and unfortunately it is sometimes necessary for staff to wake you up to perform assessments or interventions multiple times during the night.

But there are some things you can do to sleep better (without taking medications).
Here are 12 strategies that might help you to get a better nights sleep in hospital.

Not sleeping well results in plenty of negative effects when you are at home too.

1. Pain management.

It is extremely difficult to get any sleep if you are experiencing discomfort or pain.
Anticipate nocturnal pain before you settle for the night and discuss suitable analgesia coverage with your medical team.
If you are experiencing pain in the middle of the night don’t feel you have to ‘tough it out’ until morning. Use your call bell and let the nursing staff know.

2. Block sound and light.

On a typical night on the hospital wards there will be multiple interruptions.
New patients arriving from the emergency department, nurses performing essential overnight observations, equipment alarms and staff pagers going off, emergencies occurring, the person next to you snoring like a chainsaw.

A very effective way to help block all this is with a simple kit of ear plugs and an eye mask.

3. Get away from the door.

If you are in a 2 bed or 4 bed ward and you are next to the doorway, you are more likely to be disturbed:

  1. By noises coming from the corridor or nurses station.
  2. By new patients arriving during the night and passing by your bed.
    This is especially disruptive in small 2 bed wards where admitting a new patient involves squeezing their bed/trolley past your own bed area.

If this is a problem for you, ask nursing staff if it is possible to relocate (and it’s not always possible).

4. Bring in your own pillow.

We always sleep better with our favourite pillow right?
Just remember that in hospital pillows are valued items, and tend to be moved around. A lot.
So make sure it is clearly identified.

5. Discuss pre existing sleep issues.

Do you suffer from sleep apnoea or other sleep disturbing disorders?
It is a good idea to discuss this with your medical team so they can be managed.

6. Minimise the worrying.

Worry and anxiety are huge sleep interrupters.

Common causes of ruminating and worrying at night include:

  • Existential crisis. Worrying about your own mortality or having intrusive thoughts of death.
    This is probably going on a lot more than is acknowledged on hospital wards.
  • Not knowing what is going on. Uncertainty around your diagnosis or treatment. Not knowing what is going to happen next. Feeling you haven’t understood what the doctors have been telling you.
  • Fear of upcoming procedures or interventions.
  • Concerns about family or domestic situations.
  • Financial concerns.

The best way to sort these issues out is to first write them down (this is an important step) and then ask to talk about them with your nurse (they will then involve relevant doctors, social workers or other specialists). Having your worries sorted out, or even just the very act of discussing them, can make a big difference to your quality of sleep.

7. Try this 2 min technique to fall asleep.

Use some form of relaxation practice as a sleep trigger.
There are many available online as guided meditations you can download and listen to with your headphones.

You can also try this 4 step system allegedly taught to US soldiers so they can get some sleep in combat environments.

  1. Relax all the muscles in your face, including tongue, jaw and the muscles around the eyes
  2. Drop your shoulders as far down as they’ll go, followed by your upper and lower arm, one side at a time
  3. Breathe out, relaxing your chest followed by your legs, starting from the thighs and working down
  4. Spend 10 seconds trying to clear your mind before thinking about one of the three following images:
  • You’re lying in a canoe on a calm lake with nothing but a clear blue sky above you
  • You’re lying in a black velvet hammock in a pitch-black room
  • You say ‘don’t think, don’t think, don’t think’ to yourself over and over for about 10 seconds. [via]

8. Talk to your roommates.

If appropriate, talk to the other patients in your room.
Chances are they are also having difficulty getting a good nights sleep.

You might all agree as a group to minimise use of TV or electronic devices in the evenings or to keep evening visitor noise to a minimum.
Or come up with other ideas as a group.

9. Keep active during the day.

Of course, this is not always possible depending on why you are in hospital. And sometimes a whole lot of extra sleep is just what you need.

But frequent naps throughout the day and remaining sedentary on your bed all day long may be a reason you can’t sleep at night.
Get up and go for a walk at regular times during the day (just let the ward staff know where you are going).

10. Minimise stimulants.

Avoid caffeine 4-6 hours before bedtime.
Let your family know what time you are going to sleep to prevent interruptions.

11. Keep warm or keep cool.

Anticipate any changes in temperature overnight.
If it is going to get cooler overnight ask for an extra blanket that you can pull up if you need it.

12. Have a clear sleep trajectory.

Finally, have a clear trajectory approaching bedtime.
Try not to stay up too late. Set a regular time (even if it is earlier than usual for you) to go to sleep each night and try to stick to it.
Limit screen time (electronic screens can interfere with sleep patterns) a few hours before you are going to turn in.
Consider taking a warm shower just before bedtime.
Say goodnight to your roommates.
Implement as many of these strategies as you can. Discard those that don’t help.

And finally, finally….if you continue to have persisting problems getting enough sleep, you need to discuss other sleep options with your treating team.

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