In nursing, there is a predominate attitude that patients are allowed to sleep when there are no other items on the agenda. Dogan et al (2005) confirms that sleep is not given much importance when caring for hospitalized patients.
Sleep deprivation occurs when people are not allowed to get the adequate amount of sleep during the appropriate time span within a 24-hour period (Suzuki et al, 2004). This being the case, are hospitalized patients sleep-deprived? And does it affect them cognitively?
Gais & Born (2004) and Drosopoulos et al (2005) reviewed a series of research studies conducted by psychology professors that showed that a lack of adequate sleep has negative effects on short-term memory, learning, and cognitive ability.
Physically, adequate sleep is needed for maintenance of good health, and according to Dogan et al (2005) illness requires an increase in sleep. Hortwitz & McCall (2004) have written many articles on sleep deprivation and its effects. In their 2004 article, they showed how a lack of adequate sleep has been linked to increases in cardiovascular and gastrointestinal disorders and depression.
Studies have been conducted in controlled settings and real life settings to test the effects of sleep deprivation on healthy individuals. Conduit et al (2004) and Himashree et al (2002) conducted studies in a sleep lab where healthy individuals were deprived of sleep and then given a written test to evaluate the effects on their learning, cognitive skills, and memory. These studies showed a significant decline in cognitive and short-term memory and a decrease in material learned prior to the instance of sleep deprivation.
The real-life setting study used residents and interns who had been on call for at least 2-3 days consecutively. Curet & McAdam (2003) tested cognitive skills in residents after being on call. Other studies tested the quality of work of resident having been deprived of sleep. Both studies showed a decline in the cognitive and functioning capabilities of these residents and interns.
The Lee & Lipscomb (2003) study showed the correlation between sleep deprivation and poor grades in high school students. Students were given a written survey inquiring about grades and hours of sleep.
The results of that survey showed a relationship to students with low grades and less than eight hours of sleep per night and students with high grades and 8-9 hours of sleep per night. Furthermore, the survey showed students with low grades tended to get less sleep on weekends than during the week, while among the students with higher grades, sleep patterns were unchanged.
The aforementioned studies were conducted on healthy individuals. Minnaar (2003) Por et al (2004), & Towers et al (2003) did a study on hospitalized patients and their needs. The study was conducted by survey from the perspective of the patients and nurses. The results showed that the patients felt that sleep, tiredness, and fatigue were more of a problem than the nurses DID. The patients cited irritability, bad temper, and depression as resulting from lack of sleep. The Suzuki et al (2004) studies showed some of the same effects from sleep deprivation.
The negative effects of deprivation generally fall into five areas. The most common area affected by sleep deprivation was that of impairment in cognitive ability. This includes difficulty thinking clearly and performing simple mathematical skills (Curet & Adams, 2003, & Watanabe et al, 2004), decreased problem-solving ability (Girard, 2003, & Watanabe et al, 2004), a lessening ability to make decisions (Castledine, 2005, Horwitz, 2004, & Celik et al, 2005), and decreased ability in learning (Drosopoulos, 2005, Gais & Born, 2004).
The second-most common area was that of daytime sleepiness, which included a decrease in daytime alertness (Scott, 2004 & Dexter et al, 2003), difficulty staying awake during the day, and a general feeling of fatigue and loss of energy (Castledine, 2005, Scott, 2004, & Ruggiero, 2003).
Short-term memory was the third area. This is important in terms of its impact on patient care due to the complex explanations of diagnosis and procedures that patients are receiving, as well as instructions concerning medications and procedures (Curet & McAdams, 2003 & Watanabe et al, 2004).
The fourth area mentioned in sleep deprivation was mood alteration. Irritability was most frequently mentioned (Curet & McAdams, 2003 & Josten et al, 2003) along with anger (Dogan et al, 2005, & Justic, 2000), depression (Horwitz, 2004, & Honkus, 2003), and a generalized decrease in mood (McVicar, 2003, Poissonet et al, 2001).
The fifth area of sleep deprivation effects was very broad, and included other physiological responses and the effects that sleep deprivation has on the immune system (Barger et al, 2005, Lee et al, 2004, Samel et al, 2004 & Van Dogen et al, 2004). These studies were inconclusive, however. There was no definite relationship identified between sleep deprivation and changes in immune function.