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Protecting Sleep in the Hospital, for Both Patients and Doctors

nytimes.com

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Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#51

Post by jcims »

busymom0 wrote: post #32
jcims wrote: post #7

My wife has been in the hospital regularly over the past 18 months probably 20 days total. This is a renowned research hospital with a gorgeous, vibrant facility and spacious rooms. They absolutely 100% ignore any semblance of a sleep cycle for their patients (as well as proper nutrition but that's for another day). Constant interruptions to check vitals, ask if we want to pick a meal, beeping infusion pumps, a whole…

If you need help developing the app, let me know! I do iOS and Android development so maybe I can help a bit. I haven’t worked in the sleep cycle field but we can figure out things maybe.

Hey that's extremely generous of you...thank you! It will probably take some time as I'm looking at various bits of hardware to experiment with, but if I get stuck I very well may reach out to see if you have a few cycles to assist. Much appreciated!

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#52

Post by GaurVimen »

Good luck trying to change the hospital mindset. Doctors actually have a term for patients who suffer sleep deprivation: hospital-induced-psychosis. It should be called a crime and the head nurse and doctor in charge of the patient ought to be arrested.

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#53

Post by johnchristopher »

phire wrote: post #34
AlphaWeaver wrote: post #19

Earlier quoted context omitted.

> I'd like to find a watch/fitbit for her and either find or write an app that just fills the screen with a color based on her current sleep phase... Related to this: I looked into trying to get real time sleep data found it surprisingly hard. Fitbit, for example, only makes sleep data available after sleeping is over and the device is synced to the cloud. If anyone has a good solution to this I'm all ears.

An accelerometer based approach (which the fitbit uses) can't actually tell the difference between someone who is just lying there still and someone who is in deep sleep. All it can do is measure movement (which might mean they are awake, or it might mean they are in REM) and no movement. Then it can post-process it later and use the length of stillness and the patterns/amount of movement to infer probable sleep cycl…

Could EEG sensors be commoditizated ? I have sleep apnea and I find my fitbit + the CPAP readings lacking.

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#54

Post by johnchristopher »

aperrien wrote: post #38
phire wrote: post #34

Earlier quoted context omitted.

An accelerometer based approach (which the fitbit uses) can't actually tell the difference between someone who is just lying there still and someone who is in deep sleep. All it can do is measure movement (which might mean they are awake, or it might mean they are in REM) and no movement. Then it can post-process it later and use the length of stillness and the patterns/amount of movement to infer probable sleep cycl…

Maybe you could with some sort of mask that measures eye movement?

Can eyes movement be measured through eyelids ?

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#55

Post by adrianN »

johnchristopher wrote: post #53
phire wrote: post #34

Earlier quoted context omitted.

An accelerometer based approach (which the fitbit uses) can't actually tell the difference between someone who is just lying there still and someone who is in deep sleep. All it can do is measure movement (which might mean they are awake, or it might mean they are in REM) and no movement. Then it can post-process it later and use the length of stillness and the patterns/amount of movement to infer probable sleep cycl…

Could EEG sensors be commoditizated ? I have sleep apnea and I find my fitbit + the CPAP readings lacking.

They have been: https://www.gwern.net/Zeo

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#56

Post by Tharkun »

Aromasin wrote: post #27
Tharkun wrote: post #20

I know that sleep is critical to healing. And I know that a lot of what happens to you in a hospital is very unpleasant. And I know that some things might seem silly, banal or irrelevant. But please remember that this is all done from a desire to keep you and other patients alive and (relatively) well. Hospitals are always understaffed. Doctors and nurses don't have the time to keep the sleeping schedule of all their…

It's basic cost-benefit analysis. I completely appreciate where you're coming from, but despite all your points many of the checks are still silly, banal and irrelevant - the benefit of waking someone up mid sleep cycle to ask them what they want to eat, or to get them to fill out a questionnaire, or to take a blood sample when they've only had one an hour or two before, is not worth the cost. You're giving a passion…

If they're waking you up to take blood samples when you're sleeping, it's probably for good reason. Maybe the patient is at risk for some kind of kidney complications and maybe not dying from renal failure is more important than getting a good night's sleep. There could be any number of reasons for this. Maybe another patient had some kind of emergency that had to be dealt with first, and your sleep schedule is less important than someone else's life.

Generally speaking, doctors and nurses care about patients (some more than others, sure). They're also aware of the importance of sleep. If you're a nurse on a night shift, and you have to take care of a ward of 20 patients, you'll quickly find yourself too busy to be terribly considerate. Especially when something unexpected happens.

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#57

Post by C1sc0cat »

Scoundreller wrote: post #29
jcims wrote: post #7

My wife has been in the hospital regularly over the past 18 months probably 20 days total. This is a renowned research hospital with a gorgeous, vibrant facility and spacious rooms. They absolutely 100% ignore any semblance of a sleep cycle for their patients (as well as proper nutrition but that's for another day). Constant interruptions to check vitals, ask if we want to pick a meal, beeping infusion pumps, a whole…

> research hospital > a whole squad going on rounds with banal questions I’m sure there’s a better way, but that’s par for the course for a research/teaching hospital. The patient’s room is a real-life classroom and lab, with everything that goes along with that.

And also for handover between shifts - information going missing is a risk here

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#58

Post by johnchristopher »

adrianN wrote: post #55
johnchristopher wrote: post #53

Earlier quoted context omitted.

Could EEG sensors be commoditizated ? I have sleep apnea and I find my fitbit + the CPAP readings lacking.

They have been: https://www.gwern.net/Zeo

Thanks. The company behind the Zeo is out of business though. Are you aware of any alternative ?

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#59

Post by C1sc0cat »

HeraldEmbar wrote: post #31

The arrogance of nurses and physicians in constantly waking patients up, completely unaware and uncaring of the health detriment that comes with loss of sleep, is inexcusable. While some people can go back to sleep after being awakened, there are many of us who have real difficulty getting back to sleep, and sometimes it doesn't happen at all.

You know there may be other patients needs here, I recall being woken up on the higher risk renal ward, the nurses apologized but they needed to move my bed to the other side of the bay as they needed my bay (which had all the kit for monitoring) for an emergency admission.

When you overhear the nurses commenting " its xxxxx he might die in the night - you might think getting woken up is not that important.

Re: Protecting Sleep in the Hospital, for Both Patients and Doctors

#60

Post by joshgel »

HeraldEmbar wrote: post #31

The arrogance of nurses and physicians in constantly waking patients up, completely unaware and uncaring of the health detriment that comes with loss of sleep, is inexcusable. While some people can go back to sleep after being awakened, there are many of us who have real difficulty getting back to sleep, and sometimes it doesn't happen at all.

That’s a bit to far in my opinion. I’m a physician. Now days, if you are admitted to a hospital overnight it implies you are probably pretty ill. We push hard to ensure that only patients that need to be in the hospital are (wasn’t always that way). Sometimes in sick patients, checking vitals is required (to make sure you aren’t dying). Additionally, there is evidence that hourly rounding prevents some bad outcomes like patient falls. So ‘well-meaning’ institutions like mine, mandate hourly rounding by nursing staff.

Now is this absurd in some patients, yes! In very elderly patients this may do more harm than good by causing delirium, which can be deadly...

Personally, I go out of my way to not wake anyone up, but that’s often not an option in some situations.

But to say it is doctor or nursing arrogance is to not really understand healthcare.

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