Aatir H. Rajput 21 Annals of Psychophysiology Volume 3, October 2016 ©Advance Educational Institute & Research Centre www.aeirc-edu.com ISSN 2412 - 3188 Original Article Relation between quality and quantity of sleep and psychological distress among hospitalized patients Aatir H. Rajput 1 , Nimra Aslam 2 , Farheen Yousaf 3 & Muhammad Muneeb 4 Liaquat University Hospital 1 & 4 LUMHS Research Forum 1, 2, 3 & 4 Sir Cowasjee Jehangir Institute of Psychiatry, Hyderabad 1 & 4 Liaquat University of Medical & Health Sciences, Jamshoro 1, 2, 3 & 4 Corresponding email: aatirh.rajput@gmail.com Abstract Background Sleep is a fundamental component of good health, however its promotion in acute hospital settings does not appear to be a priority. Causes of sleep disruption are varied and include environmental and bio-cognitive factors, including pain, bright light, noise, anxiety and stress. The environmental and bio-cognitive consequences of sleep deprivation on the health and recovery of hospital inpatients are various. Inadequate sleep can lead to both psychological and physiological consequences. Objective This observational study was aimed at determining the pattern, quantity and quality of sleep and the prevalence, causes and effect of sleep deprivation / disturbance among patients hospitalized at the elective wards of a tertiary care hospital. Methods This observational study was conducted from August 2015 to January 2016, upon a sample of 50 patients admitted to Liaquat University Hospital (who had spent at least 4 weeks at the hospital). The sample of patients (chosen via simple random sampling), were interviewed consecutively every morning for 4 days and their mean response was evaluated to account for irregularities in experience. Data was collected using interview based structured questionnaire which included the 42 point DAS scale approved by Australian Center for Posttraumatic Mental Health. The data was analyzed in SPSS v. 17.0 and MS Excel 2013. Results During the stay at the hospital, DAS score of depression, anxiety and stress all rose. The most reported bothersome elements that disturbed sleep included, pain (30%), Noise (6%), and feeling of unease, irritation and panic (6%). Majority of the sample comprised of female (56%) respondents coming from rural areas (74%) with a low socioeconomic background (86%). The quantity of sleep dwindled between (but not more than) 5 to 6 hours. The quality too (self-rated by the respondents did not rise above a value of 6.5. Conclusion The conclusion is in line with our hypothesis. With the hustle and bustle happening at all hours in a hospital, patients have trouble getting adequate sleep, which has an evident the quality and quantity of sleep during their stay. Owing to the belief that sleep-deprived patients are less likely to be fully active participants in their care. It is recommended that steps should be taken to deal with this problem on a priority basis. Keywords Sleep, depression, anxiety, stress, psychological distress. Introduction Sleep is a fundamental component of good health, however its promotion in acute hospital settings does not appear to be a priority. Causes of sleep disruption are varied and include environmental and bio- cognitive factors, including pain, bright light, noise, anxiety and stress. The environmental and bio- cognitive consequences of sleep deprivation on the health and recovery of hospital inpatients are various. Inadequate sleep can lead to both psychological and physiological consequences. Hospitalized patients, particularly those who are critically ill, are known to have severe sleep fragmentation and disturbed sleep. The sleep typical of an ill patient is characterized by a predominance of wakefulness and light sleep (sleep stages I and II), and a relative lack of rapid eye movement (REM) and deep sleep (delta sleep, formerly referred to as non- REM sleep stages III/IV) (Cooper AB. et al, 2000; Aurell J. et al, 1985; Freedman NS. et al, 2001; Gabor J. et al, 2003). Sleep deprivation is known to lead to several clinical, physiologic and psychological manifestations such as depression, anxiety and stress. Dement and Vaughan studied the effects of prolonged wakefulness, and observed that healthy volunteers who were sleep deprived would become confused, ill-tempered, and extremely sleepy; however, they never became either psychotic or hyperactively delirious (Dement WC. et al, 1999). The longest observed case of sleep deprivation involved an 18-year-old who stayed awake for 264 hours. At times during his long-term sleep deprivation, he would become angry that he was not