Nurse-Led Microclimate Adjustments in Patient Rooms and Their Physiological Impact on Sleep Quality Recovery
DOI:
https://doi.org/10.61919/jw1a3z83Keywords:
Circadian Rhythm; Heart Rate Variability; Hospitalization; Nursing Care; Patient Comfort; Sleep Quality; Temperature ComfortAbstract
Background: Sleep disturbance is common among hospitalized adults and may impair physiological recovery, increase fatigue, and reduce patient comfort. Environmental factors such as room temperature, light exposure, noise, airflow, and bedding comfort are potentially modifiable contributors to inpatient sleep disruption. Objective: To evaluate the effect of nurse-led environmental microclimate adjustment on sleep quality and physiological sleep-recovery markers among hospitalized adults. Methods: A parallel-group randomized controlled trial was conducted in medical and post-surgical recovery wards of a tertiary care hospital in Central Punjab, Pakistan, from August 2025 to January 2026. Seventy-two adults with baseline sleep disturbance were randomized to structured nurse-led microclimate adjustment or routine ward care. The intervention targeted nighttime temperature, lighting, noise, airflow, and bedding comfort over 14 nights. Baseline characteristics were analyzed in all randomized participants, while post-intervention outcomes were analyzed among 65 participants with complete outcome data. Results: Post-intervention PSQI scores were lower in the intervention group than controls (5.9 ± 1.7 vs 8.8 ± 2.0; mean difference −2.9; 95% CI −3.8 to −2.0; p<0.001). The intervention group also showed fewer nighttime awakenings, higher oxygen saturation, greater heart rate variability, lower fatigue severity, and higher comfort scores. Comfort was inversely correlated with PSQI score (r=−0.61; p<0.001). Conclusion: Nurse-led microclimate adjustment was associated with improved sleep quality, comfort, fatigue, and physiological sleep-recovery markers in hospitalized adults. Larger multicenter trials with objective sleep monitoring and adjusted analyses are recommended.
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Copyright (c) 2026 Abrar Hussain, Sadia Iqbal, Anum Rehman, Syed Maaz Hussain, Abdullah Khan, Ayesha Rehman (Author)
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