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Why Do Hospitals Hate Sleep So Much?

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171–180 of 528 posts

Re: Why Do Hospitals Hate Sleep So Much?

#171
I spent a week in a German hospital a few years back. One thing that struck me is that they offered sleeping pills to ensure patients got a good night of sleep. Worked for me. Also didn't notice too many interruptions at night.

Another trend that I know of in the Netherlands (where I'm from) is that newly built hospitals have private rooms for all patients. These hospitals no longer have shared rooms by design. They also try to minimize hospital stays as being in a hospital exposes you to hospital infections, is expensive, and to be avoided unless explicitly needed.

That's a big difference with Germany, which is old fashioned on this front. The default attitude in Germany seems to be to keep people in a hospital much longer. In Germany you only get a private room if you need it medically or if you take private insurance.

I suspect a lot of this stuff is part cultural and part wrongly aligned incentives because hospitals just bill whatever to insurers and couldn't care less about patient comfort because their paying customer is the insurer, not the patient. The insurer cares about cost, the hospital cares about milking the insurer to the maximum of their ability. Between those two, patient comfort is not much of a concern.

The reason things have improved in the Netherlands is that they spent the last decade realigning incentives to cut cost between insurers and hospitals. People pick their own insurer (they are all private). However, all insurers are required to offer the same base packages (with extras if you want). So, people can easily switch insurance provider if they want and they do. So, insurers now compete on quality of service and cost. Which is why a lot of hospitals are actively concerning them selves with upgrading their facilities to improve customer happiness (still the insurers). Insurers are happy when their customers don't switch to another insurer and when hospitals don't waste their money.

Re: Why Do Hospitals Hate Sleep So Much?

#172
post #143

Earlier quoted context omitted.

>Copenhagen, Denmark, so the entire stay was ~~free~~ subsidized.

Is it free to walk down the sidewalk in your country? Under your definition it's not, since ultimately taxes likely paid for that sidewalk, but I think most people would describe it as free.

Depends on if you think in purely capitalistic terms (most but not all Americans) or not (again, most Europeans). I mean one way to think about it is the sidewalk is exploitable by businesses as a potential source of revenue for people who want to ride electric scooters (and other businesses that directly grow the economy) and they can pay lobbyists who drive the engine of American economic growth (lol), whereas you as a pedestrian is hardly doing an activity on that sidewalk that directly contributes to economic growth, so yeah, in a way you are getting your walk down the “free” sidewalk subsidized.

Re: Why Do Hospitals Hate Sleep So Much?

#173
post #172
post #143

Earlier quoted context omitted.

Is it free to walk down the sidewalk in your country? Under your definition it's not, since ultimately taxes likely paid for that sidewalk, but I think most people would describe it as free.

Depends on if you think in purely capitalistic terms (most but not all Americans) or not (again, most Europeans). I mean one way to think about it is the sidewalk is exploitable by businesses as a potential source of revenue for people who want to ride electric scooters (and other businesses that directly grow the economy) and they can pay lobbyists who drive the engine of American economic growth (lol), whereas you…

Dude. Nobody talks like this. Sidewalks are free. Roads are free except when tolled. The library is free. Facebook is free.

This is a ridiculous conversation.

Re: Why Do Hospitals Hate Sleep So Much?

#174

I spent a week in a German hospital a few years back. One thing that struck me is that they offered sleeping pills to ensure patients got a good night of sleep. Worked for me. Also didn't notice too many interruptions at night. Another trend that I know of in the Netherlands (where I'm from) is that newly built hospitals have private rooms for all patients. These hospitals no longer have shared rooms by design. They…

How does that work: insurers trying to keep as many customers as possible is disjoint from the customer satisfaction a patient has when receiveing healthcare at a hospital.

As a patient I don't think about my insurer when I'm at a hospital. I just want to be treated.

It's more likely to be the opposite, where the hospitals with the better healthcare and care of the patients have to spend more money and thus get less contracts with the insurers, who have an incentive to reduce cost as much as possible. Out of the 4 hospitals I've visited for healthcare in my area, only 1 will currently be covered by insurers in their most basic plan next year, and that one is the most remote.

Basically, next year I cannot visit my regular hospitals to continue my current treatment plan without getting a more expensive basic healthcare plan (+15%, or roughly 220euro).

Re: Why Do Hospitals Hate Sleep So Much?

#175

I recently had a family member in the intensive care unit (ICU) for over a month in Austin, Texas. I quickly learned my main contribution would be protecting her sleep when I saw she hadn't slept in days because of the constant interruptions. She went from reasonable and compliant in taking her medication, to extremely irritated and noncompliant with the doctors. Of course I could see this was due to sleep deprivatio…

To get up to speed on how dramatically sleep affects our cognitive performance, listen to this excellent interview with Matthew Walker (Professor of Neuroscience and Psychology at UC Berkeley, and Director of the Center for Human Sleep Science)

https://www.youtube.com/watch?v=pwaWilO_Pig

https://podtail.com/en/podcast/the-joe-rogan-experience/-110...

Re: Why Do Hospitals Hate Sleep So Much?

#176
post #143

Earlier quoted context omitted.

>Copenhagen, Denmark, so the entire stay was ~~free~~ subsidized.

Is it free to walk down the sidewalk in your country? Under your definition it's not, since ultimately taxes likely paid for that sidewalk, but I think most people would describe it as free.

That's a little different in as much as there's negligible marginal cost to walking down the sidewalk, once it is constructed. The same is not true of a marginal hospital stay.

Re: Why Do Hospitals Hate Sleep So Much?

#177

For both of our children, the hospital caused us more stress and discomfort than anything else. Newborn baby's finally asleep, wife is comfortable re pain, finally start to get some sleep. Then the nurse comes in at 2 am, writes her name on the board, asks us questions that they should have the answer to, then leaves. Nurse change 3x a day, baby doctor checking in to ask if were ok, mom doctor doing the same, house k…

Yeah, my wife and I fled the maternity/recovery ward ASAP after both of our children, because it was so hard to rest and so unpleasant there.

The first time, my wife had preeclampsia during the labor and, fair enough, there were some significant interventions to make sure that her recovery was going apace. But the second time? She had a textbook uncomplicated delivery and fundamentally all we were doing was waiting to make sure that nothing crazy cropped up in the first 48 hours after birth. There was no reason for disruptions in our rest every hour or two.

Re: Why Do Hospitals Hate Sleep So Much?

#178
post #22

Not only are they "designed to allow patients as little sleep as possible", but also doctors too. Residents and doctors frequently have take on 30-36 hour shifts.. How they could effectively treat patients with this level sleep deprivation is beyond me. Maybe hospitals just have a vendetta on sleep in general?

It's because doctor handovers are surprisingly dangerous.

This is the usual answer but countries closer to the European Working Time Directive have better outcomes.

Re: Why Do Hospitals Hate Sleep So Much?

#179
Hate is a strong word but I found myself hating my hospital stay because I felt trapped, I was unable to do anything for five days but be in my room, watching shark week over and over again. All that time just for tests. Tests take up time and money and at one point I scared my family badly with a few results. I think it's a combination of worry, stress, being awoken up every few hours and just being unable to do normal things- like taking a dump without the need for other people to know!

Re: Why Do Hospitals Hate Sleep So Much?

#180

I recently had a family member in the intensive care unit (ICU) for over a month in Austin, Texas. I quickly learned my main contribution would be protecting her sleep when I saw she hadn't slept in days because of the constant interruptions. She went from reasonable and compliant in taking her medication, to extremely irritated and noncompliant with the doctors. Of course I could see this was due to sleep deprivatio…

> intensive care unit (ICU)

There are only two reasons for someone to be in an ICU: they require a therapy no other floor will administer, or their condition/therapy requires very frequent administration/titration/observation. These two reasons frequently overlap.

Sleep isn’t optional in general. It’s optional in the ICU, because the premise is “if you don’t need this level of attention to survive, you absolutely shouldn’t be on this unit.”

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