While you were sleeping
Archived article from Feb 11, 2000
By Diane Cornell
Since one-third of our life is spent sleeping, it is good to know that this is time well spent. In fact, as the research below illustrates, our brains and bodies may do some of their most important work while we sleep. Rest and recovery
It is an old story: a hospital is no place for rest. As those who have ever spent a night in one can attest, the one time you need your sleep, it is nearly impossible to get it. Nancy Redeker, an associate professor at the College of Nursing, does more than sympathize. She is actively researching how lack of sleep influences patient recovery.
Redeker began her research into the consequences of sleep loss in the early 1990s after a stint as a cardiac-care nurse at St. Michael's Medical Center in Newark. It was at the medical center that she became interested in the recovery of patients over time. "I wanted to find out what we could teach patients that would help promote their recovery," she says.
Her current study examines how sleep affects patients who are recovering from open-heart surgery. Although most patients stay in the hospital less than a week after cardiac surgery, sleep disruptions, which can affect mood, cognitive abilities and immune function, may continue for up to six months or more.
Redeker's research looks at the extent to which "sleep disturbances have an impact on our lives, in the hope that we may then go on to document some interventions to help improve sleep," such as medications or behavioral changes.
Unlike other researchers, Redeker is specifically looking at the risks for people who have sleep problems that predate their admission to the hospital. She recruits such patients pre-operatively, theorizing that they may be at higher risk post-operatively. In addition to investigating the importance of sleep, she is examining if a lack of sleep affects men and women differently and whether other factors such as age play a role.
Part of her work, which is funded by a grant from the National Institutes of Health, looks at what conditions in an acute-care setting play a part in sleep disruptions. "By surveying patients, we found it is not only the noise or the bright lights. Most people say these factors did not bother them as much as the nurses and doctors and other health-care professionals who come in at all hours of the night to check temperatures or blood pressures or do other procedures," Redeker says.
She is exploring how much of this care is vital and what can wait until morning. "We are looking at how we can better manage the care of acutely ill patients. We want to find out what we can safely cut down on or pattern better to let patients have more undisturbed sleep," she says.
Redeker is also examining ways to measure sleep. Traditionally, sleep research is conducted in the artificial environment of a sleep lab, where a person is wired to cumbersome machines that record brain activity, eye movement and breathing patterns. But Redeker is finding ways to record measurements in a more natural environment as people go from the hospital to their homes.
Her subjects wear an electronic device, on their nondominant wrist, that records movement, relying on the notion that when we sleep, our movements cease. The device, called an actigraph, is used in conjunction with a sleep diary kept by the patient.
"We are the first people to use this device in an acute-care setting," says Redeker, who is looking to recruit 125 pre-operative, cardiac bypass patients to be followed over time. She plans to monitor them for three days before entering the hospital, three days in the hospital and then for three days at four weeks and again at eight weeks.
"We want to look at their behavior in sleep and see if that changes over time," she says. One of the difficulties she may encounter is getting a large enough sampling of women, who represent only 26 percent of the bypass-surgery candidates nationally and who tend not to do as well as men after the procedure. But, Redeker points out, women are an important group to study since they report more insomnia than men.
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