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Reorganizing nighttime medical routines significantly improves objective and subjective sleep quality in hospitalized adults

In a randomized controlled trial, an intervention protocol that rescheduled non-essential nocturnal procedures (vital sign checks, medication administration, laboratory sampling) led to longer total sleep time (geometric mean 398 vs. 301 min, p=.015) and longer REM sleep duration (79.2 vs. 58.0 min, p=.010) compared to standard care. Subjective sleep quality also improved, with lower PSQI scores at study completion (4.6 vs. 8.7, p=.040).

Last updated: Aug 26, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Effect of a nighttime medical order adjustment protocol on objective and subjective sleep quality in hospitalized adults: a randomized controlled trial.

observational

Parra-Avila S, Santos-Macías JE, Garza-Silva A, Gutierrez-González D, Fernández-Chau IF, Chong SJC, Gómez OAQ, Barrientos JGR, Romero-Ibarguengoitia ME · Sleep advances : a journal of the Sleep Research Society (2026)

Participants: N/A
Duration: 3 nights (1 baseline + 2 intervention nights)
Intervention: Nighttime medical order adjustment protocol rescheduling non-essential nocturnal procedures (routine vital signs, medications, labs) to daytime
Outcome: Objective sleep parameters (total sleep time, REM sleep duration, nocturnal awakenings) measured by Fitbit Sense; subjective sleep quality measured by Pittsburgh Sleep Quality Index (PSQI)
Effect Size: N/A (p-values reported, but no effect size)
Population: Hospitalized adults (mean age 41.2 years, 56.9% female) in general hospital wards in Latin America

Result:

PubMed: 42639589DOI: 10.1093/sleepadvances/zpag079

Mechanism Graph

Non-essential nighttime medical activities disrupt sleep
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Rescheduling these activities to daytime reduces nighttime interruptions
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Patients experience longer uninterrupted sleep, including REM sleep
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Improved objective and subjective sleep quality

Limitations

  • ⚠Small sample size (n=51) limits generalizability
  • ⚠Objective sleep measured with consumer wearable (Fitbit Sense) rather than polysomnography
  • ⚠Single-center study in Latin America may not generalize to other settings
  • ⚠Only two intervention nights, short-term effects unknown

Frequently Asked Questions

What was the intervention in this study?▼

The intervention was a nighttime medical order adjustment protocol that rescheduled non-essential nocturnal procedures (routine vital sign checks, medication administration, laboratory sampling) to daytime hours.

How was sleep quality measured?▼

Objective sleep parameters (total sleep time, REM sleep duration, awakenings) were monitored using Fitbit Sense over three nights. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at baseline and study completion.

What were the main results?▼

The intervention group had significantly longer total sleep time (398 vs. 301 min) and REM sleep duration (79.2 vs. 58.0 min) compared to controls. PSQI scores were also lower (4.6 vs. 8.7), indicating better subjective sleep quality.

Who were the participants?▼

The study included 51 hospitalized adults (mean age 41.2 years, 56.9% female) in general hospital wards in Latin America.

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References

  1. 1.Parra-Avila S, Santos-Macías JE, Garza-Silva A, Gutierrez-González D, Fernández-Chau IF, Chong SJC, Gómez OAQ, Barrientos JGR, Romero-Ibarguengoitia ME. "Effect of a nighttime medical order adjustment protocol on objective and subjective sleep quality in hospitalized adults: a randomized controlled trial.." Sleep advances : a journal of the Sleep Research Society, 2026. PMID: 42639589 DOI: 10.1093/sleepadvances/zpag079
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.