A narrative review of interventions for improving sleep and reducing circadian disruption in medical inpatients

Sleep Med. 2019 Jul;59:42-50. doi: 10.1016/j.sleep.2018.08.007. Epub 2018 Aug 24.


Sleep and circadian disruptions are frequently observed in patients across hospital wards. This is alarming, since impaired nocturnal sleep and disruption of a normal circadian rhythm can compromise health and disturb processes involved in recovery from illness (eg, immune functions). With this in mind, the present narrative review discusses how patient characteristics (sleep disorders, anxiety, stress, chronotype, and disease), hospital routines (pain management, timing of medication, nocturnal vital sign monitoring, and physical inactivity), and hospital environment (light and noise) may all contribute to sleep disturbances and circadian misalignment in patients. We also propose hospital-based strategies that may help reduce sleep and circadian disruptions in patients admitted to the hospital.

Keywords: Circadian rhythm; Hospital; Inpatients; Sleep.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anxiety / complications
  • Hospitalization*
  • Humans
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / therapy
  • Sleep Deprivation / etiology*
  • Sleep Disorders, Circadian Rhythm / therapy*
  • Sleep Initiation and Maintenance Disorders / therapy*