CSA News

‘Sleep as medicine,’ or how to make a hospital stay less unhealthy

By Katherine Ellison | Feb 21, 2023

Blood draws at the crack of dawn. The endless beeps and chimes of electronic monitors. Loud conversations in hallways.

For a long list of reasons, many patients don’t sleep well in U.S. hospitals. Yet while medical errors and health-care acquired infections have inspired major reforms, the toll of poor sleep gets less attention, say experts who want that to change.


“The hospital itself and its barrage of stress can become a toxic place — a place actively causing harm,” Yale cardiologist Harlan Krumholz argues.

He and other experts count sleep deprivation as a key contributor to “post-hospital syndrome” — Krumholz’s term for the weakened immune systems, loss of body mass and other impairments that land many people back in a hospital soon after discharge.

“The hospital itself and its barrage of stress can become a toxic place — a place actively causing harm.”
— Harlan Krumholz, Yale cardiologist

Krumholz first explored “post-hospital syndrome” in a New England Journal of Medicine article, writing: “At the time of discharge, the physiological systems are impaired, physiological reserves are depleted, and the body cannot effectively avoid or mitigate health threats.”

Ten years have passed since then, and he says, “it gnaws at me that I’m somehow not able to get people’s attention.”

An exception came Jan. 22, however, after Krumholz tweeted about a major hospital sleep disrupter: the frequent early-morning blood draws he and colleagues have documented at Yale New Haven Hospital. Researchers found that 4 in 10 blood draws occurred before 7 a.m.


“Sleep as medicine,” Krumholz wrote on Twitter, following up with some pragmatic suggestions. What if doctors stopped ordering routine blood draws before 7 a.m.? What if, instead, they wrote orders for seven hours of peace and quiet?

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