Scoping review of the measurement of care environment factors that impact sleep in the rehabilitation, subacute, and aged care settings.

Study Objectives: Unfamiliar environments are often poorly conducive to quality sleep, especially for patients within health and aged care settings. This scoping review aims to map available evidence regarding the sleep environment in rehabilitation, subacute, and aged care settings. It examines how these factors are measured and seeks to identify any reported standard metrics, guidelines, or methodologies. Methods: Searches were conducted within PubMed, EMBASE, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, and Web of Science from database inception to May 2023. Eligibility criteria included original studies of any design reporting on the measurement properties of care environment factors affecting the sleep of adult patients admitted to rehabilitation, subacute wards, and aged care facilities. Results: Seventy-four studies were reviewed that included 5055 participants, mostly (78.4%, 58/74) from aged care facilities. From 102 identified care environment factors, the spectral measurements of light were most reported (65.7%, 67/102), with methodologies varying from actigraphy and illuminance meters to pendant-style light monitors. Other environmental factors (sound, temperature, and air quality/humidity), room characteristics (mattress/bedding, room cohabitation), and hospital functioning (imposed schedules) were measured considerably less often and displayed similar variations in reported units and devices. Eighteen studies reported international, national, and methodological standards or guidelines. Conclusions: This review provides a comprehensive overview of the care environment factors affecting sleep studied within rehabilitation, subacute, and aged care settings. Various units and devices were used in measuring these factors, and standard metrics and methodology were not consistently used. Future care environment studies incorporating interventions that employ standardized devices, units, and methodologies, will thereby enhance the reliability and comparability of findings within this field.