Sleep and activity patterns in older patients discharged from the hospital

Riley Kessler, Kristen L. Knutson, Babak Mokhlesi, Samantha L. Anderson, Monica Shah, David O. Meltzer, Vineet M. Arora*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Study Objectives: Although sleep disturbance is common in acutely ill patients during and after a hospitalization, how hospitalization affects sleep in general medicine patients has not been well characterized. We describe how sleep and activity patterns vary during and after hospitalization in a small population of older, predominately African American general medicine patients. Methods: Patients wore a wrist accelerometer during hospitalization and post-discharge to provide objective measurements of sleep duration, efficiency, and physical activity. Random effects linear regression models clustered by subject were used to test associations between sleep and activity parameters across study days from hospitalization through post-discharge. Results: We recorded 404 nights and 384 days from 54 patients. Neither nighttime sleep duration nor sleep efficiency increased from hospitalization through post-discharge (320.2 vs. 320.2 min, p = 0.99; 74.0% vs. 71.7%, p = 0.24). Daytime sleep duration also showed no significant change (26.3 vs. 25.8 min/day, p = 0.5). Daytime physical activity was significantly less in-hospital compared to post-discharge (128.6 vs. 173.2 counts/min, p < 0.01) and increased 23.3 counts/min (95% CI = 16.5 to 30.6, p < 0.01) per hospital day. A study day and post-discharge period interaction was observed demonstrating slowed recovery of activity post-discharge (βas3 = -20.8, 95% CI = -28.8 to -12.8, p < 0.01). Conclusions: Nighttime sleep duration and efficiency and daytime sleep duration were similar in-hospital and post-discharge. Daytime physical activity, however, was greater post-discharge and increased more rapidly during hospitalization than post-discharge. Interventions, both in hospital and at home, to restore patient sleep and sustain activity improvements may improve patient recovery from illness.

Original languageEnglish (US)
Article numberzsz153
Issue number11
StatePublished - Nov 2019


  • activity
  • home
  • hospital
  • older adults
  • sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)


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