Table 2 Interventions to improve sleep/wake cycles and patients’ ability to fall asleep and stay asleep

Promote emotional and spiritual support (e.g., address family needs, provide comfort and peace, provide reassurance, and help with realistic expectations)

Provide educational interventions to promote sleep

Support individual circadian rhythms (e.g., adjust clinical processes and medications based on individual sleep assessments, determine causes of sleep problems, encourage a daytime routine, and avoid enforcing a traditional sleep/wake cycle)

Promote physical comfort in patients

Reduce negative stimulation and distraction

Provide patient-centered care (e.g., provide case managers and patient advocates to each patient in addition to dedicated staff members for particularly sensitive patients)

Apply monitoring and staff feedback systems

Provide disruptive and high-impact innovations that will lead to substantial improvements in multiple patients

Accommodate alternative sleeping arrangements for patients

Grant control over environment and amenities to staff, patients, and family

Create internal policies to reduce disruptive noises

Ensure that healthcare providers are trained to embrace each facility’s common philosophy

Frequently measure, communicate, and document sleep quality and the impact of interventions

Optimize daytime environments (e.g., high-quality mattresses, daylight, soothing colors and scents, individualized sounds, and fresh air)

Optimize night-time environments for sleep (e.g., keep rooms quiet and dark, eliminate odors, and provide white noise)

Provide disruptive and high-impact innovations that will lead to substantial improvements in multiple patients

Streamline national and federal reimbursement and care-related policies

Dedicate more funding and resources to end-of-life and palliative care