Sleep Patterns and Quality Among Inpatients Recovering From Elective Surgery: A Mixed-Method Study

J Surg Res. 2020 Oct;254:268-274. doi: 10.1016/j.jss.2020.04.032. Epub 2020 May 29.


Background: Sleep is necessary for recovery from physiological insults such as surgery. Although previous research has focused on sleep in the intensive care unit and medical setting, little is known about sleep quality among inpatients recovering from elective surgery. Therefore, we examined sleep quality and barriers to sleep among postsurgical inpatients.

Methods: We conducted an explanatory sequential mixed-method study among adult general-care surgical inpatients who underwent elective surgery. We used a quantitative survey to examine sleep quality and interruptions followed by a qualitative phone interview with a subsample of participants to examine barriers and aids to sleep in the hospital. Results were analyzed using descriptive statistics of survey data and descriptive coding of interview transcripts.

Results: Of 113, 102 (90%) eligible patients completed the survey. Less than half (n = 48, 47%) of patients reported sleeping well the previous night and 93% reported less sleep in the hospital compared with at home. Patients reported a median of 5 (4-7) interruptions each night. Patients with >3 sleep interruptions were more likely to report poor sleep than those with ≤3 interruptions (P < 0.001). Phone interview responses cited barriers to sleep including staff interruptions and roommate noise when sharing a room but not pain. Patients suggested that improved timing and knowledge of interruptions or noise-reduction aids would facilitate sleep.

Conclusions: Most patients do not sleep well while recovering from elective surgery in the hospital, and most sleep disruptions are modifiable. Minimizing interruptions at night by clustering care, informing patients of scheduled interruptions, and increasing access to noise-reduction aids may improve sleep quality. Optimal efforts to improve sleep quantity and quality will ultimately require a multilevel, multicomponent strategy.

Keywords: Mixed method; Quality improvement; Sleep; Sleep quality; Surgery.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Elective Surgical Procedures / rehabilitation*
  • Hospitals
  • Humans
  • Interviews as Topic
  • Sleep*
  • Surveys and Questionnaires