{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T21:20:14Z","timestamp":1787606414747,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":201,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>Sleep disruption is common among hospitalized patients and is often exacerbated by non-essential nighttime medical activities. Evidence from general hospital wards in Latin America remains limited. We evaluated the effect of an adjusted nighttime medical order protocol on sleep quality in hospitalized adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this randomized controlled trial, patients were allocated to standard care or an intervention protocol in which non-essential nocturnal procedures (routine vital sign checks, medication administration, and laboratory sampling) were rescheduled. Objective sleep parameters were monitored with Fitbit Sense over three consecutive nights. The first night served as a baseline, followed by two intervention nights. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at baseline and study completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-one patients were included [mean (SD) age 41.2 (13.0) years; 56.9% female], with 26 (51.0%) assigned to the intervention group. Compared with controls, the intervention group had longer geometric mean [geometric standard deviation (GSD)] total sleep time [398 (1.28) vs. 301 (1.40) min; p\u2009=\u2009.015] and longer estimated Stage R [rapid eye movement (REM)] sleep duration [79.2 (1.36) vs. 58.0 (1.49) min; p\u2009=\u2009.010]. In addition, nocturnal awakenings were eliminated by the second intervention night. Subjective sleep quality also improved in the intervention group, with lower PSQI scores at study completion than in the control group [4.6 (2.5) vs. 8.7 (3.2); p\u2009=\u2009.040].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reorganizing nighttime medical routines significantly improved objective and subjective sleep quality in hospitalized patients. This low-cost, pragmatic intervention may represent a scalable strategy for implementing sleep-friendly hospital practices.<\/jats:p>\n                    <jats:p>Statement of Significance Sleep disruption in hospitalized patients is common and largely driven by modifiable care practices yet remains insufficiently targeted in routine clinical care. In this randomized controlled trial, restructuring nighttime medical orders significantly improved objective sleep parameters (Stage R [rapid eye movement] sleep, non-rapid eye movement sleep, total sleep time) and subjective sleep quality in general ward patients. These findings support workflow modification as a feasible, low-cost strategy to reduce sleep disruption, and improve inpatient experience. Key gaps remain regarding durability of effects, underlying physiological mechanisms, and applicability across different healthcare settings. Future studies should evaluate longer-term outcomes and incorporate objective physiological markers to better define the role of sleep optimization as a component of high-quality hospital care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleepadvances\/zpag079","type":"journal-article","created":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T11:32:28Z","timestamp":1784460748000},"source":"Crossref","is-referenced-by-count":0,"title":["Effect of a nighttime medical order adjustment protocol on objective and subjective sleep quality in hospitalized adults: a randomized controlled trial"],"prefix":"10.1093","volume":"7","author":[{"given":"Sof\u00eda","family":"Parra-Avila","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Hospital Cl\u00ednica Nova de Monterrey , San Nicol\u00e1s de los Garza, Nuevo Le\u00f3n ,","place":["Mexico"]},{"name":"Vice-Rectory of Health Sciences, University of Monterrey , San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n 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University of Monterrey , San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n ,","place":["Mexico"]},{"name":"Teaching and Research Department, Hospital Cl\u00ednica Nova de Monterrey , San Nicol\u00e1s, Nuevo Le\u00f3n ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iv\u00e1n Francisco","family":"Fern\u00e1ndez-Chau","sequence":"additional","affiliation":[{"name":"Vice-Rectory of Health Sciences, University of Monterrey , San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Jaqueline Castruita-Von","family":"Chong","sequence":"additional","affiliation":[{"name":"Vice-Rectory of Health Sciences, University of Monterrey , San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar Alberto Quiroga","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, 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