Circadian Rhythm and Sleep Disturbances in Hospitalized Patients: Implications for Nursing Care – A Narrative Review

Abstract

Sleep is a basic physiological need that supports cognition, emotional stability, physical restoration, and recovery from illness. Hospital admission often disrupts sleep–wake patterns through environmental, clinical, psychological, and organizational factors. Noise, artificial light, nighttime procedures, pain, anxiety, unfamiliar surroundings, medication timing, and reduced daytime activity can contribute to fragmented sleep and circadian misalignment. Nurses are well positioned to identify sleep problems and modify avoidable environmental and care-related causes while maintaining patient safety. This narrative review synthesizes current literature on circadian rhythm and sleep disturbance in hospitalized patients, outlines major contributing factors, considers potential consequences, and discusses evidence-informed nursing strategies. Evidence generally supports multicomponent approaches that include sleep assessment, environmental adjustment, symptom control, daytime activity, relaxation strategies, sensory aids, and reduction of unnecessary nighttime interruptions. Evidence for individual interventions remains variable. A practical circadian-sensitive nursing framework is proposed to integrate sleep promotion into routine patient care. Protecting sleep should be considered an important component of holistic, patient-centered nursing care while maintaining individualized monitoring and clinical safety.