A large-scale study of chronic sleep disorders in psychiatric inpatients: Prevalence, hospitalization burden, restraint use, and comorbidities

Abstract

BackgroundSleep disorders are closely linked to the onset, progression and severity of psychiatric disorders, yet large-scale data from real-world inpatient settings remain limited. Evaluating the impact of chronic sleep disorders (CSD) in this context is essential for improving care.MethodsWe conducted an analysis of adult inpatients hospitalized from January 1, 2021, to December 31, 2023, using data from the Paris Psychiatry Hospital Group’s health data warehouse. Sleep disorders were identified via ICD-10 codes, hypnotic prescriptions, or mentions in medical record. CSD was defined using an Index of Length of Stays with Disorders (ILSD) >0.5, and no sleep disorders (NSD) with an ILSD of zero.ResultsAmong 13,913 psychiatric inpatients, 81% were classified as having CSD. Compared to NSD patients, those with CSD had a higher number of hospitalizations (1.84 vs 1.33, p<0.001) and increased use of seclusion (17.6% vs 13.3%, p<0.001) and physical restraint (6.6% vs 5.3%, p=0.003). Individuals with CSD were more frequently hospitalized than the NSD group for depressive disorders (15.6% vs13.1%, p<0.001), bipolar disorders (11.4% vs5.6%, p<0.001), personality disorders (5.3% vs4.3%, p=0.009), alcohol abuse (3.3% vs2.4%, p=0.005), other substance use disorders (2.9% vs2.2%, p=0.018), manic episode (2.0% vs0.9%, p<0.001), and anxiety disorders (1.4% vs0.9%, p=0.012). Hypnotics were prescribed in 50.5% of SD-related stays. The CSD group had more psychiatric and non-psychiatric comorbidities.ConclusionsCSD are highly prevalent in psychiatric inpatients and associated with more severe clinical profiles, greater hospitalization burden, and increased restraint use. Targeted sleep management strategies may help improve outcomes and care.