A Pilot Nonrandomized Trial of Noise and Light Reduction to Improve Sleep in General Medical Wards

Introduction: Insomnia is common in hospitalized patients. Whether earplugs, eye masks, and the provision of quiet times could improve patients’ sleep in a general medical ward is still unclear. Methods: In this nonrandomized pilot study, we recruited consecutive patients admitted to general medical floors over 2 months. The 1 st month was the preintervention group, and the 2 nd month was the intervention group. Interventions included the provision of earplugs and eye masks with verbal instruction, provision of information on routine laboratory draw time, scheduled quiet times, and reducing noise and light during quiet times. The Insomnia Severity Index (ISI) questionnaire was given to all patients on discharge. Results: Out of 350 screened patients, there were 106 patients in the preintervention group and 109 patients in the intervention group. Baseline demographic and clinical characteristics did not significantly differ between groups. 42.2% of patients in the intervention group and 49.1% of patients in the preintervention group had insomnia on discharge (adjusted odds ratio = 0.8, 95% confidence interval = 0.34–1.87). The mean ISI score was 7.54 ± 6.17 in the intervention group and 8.1 ± 6.71 in the preintervention group ( P = 0.17). Satisfaction score (4.22 ± 1.08 vs. 4.36 ± 0.86, P > 0.05) and duration of stay (5.14 ± 6.75 vs. 5.47 ± 6.08, P > 0.05) were not different between the two groups. Conclusions: Interventions to reduce noise and light and provide quiet time in general medical wards did not lead to a statistically significant improvement in self-reported insomnia, as well as patients’ satisfaction score and length of stay. There was a numerical trend toward improvement, but it did not reach statistical significance. Insomnia in the hospital could lead to significant impacts on patients, including depression, delirium, and hypertension, and substantially reduce patients’ satisfaction with hospital care.