Sleep health recommendations for adults receiving overnight infusions of parenteral nutrition
2022 Community Sleep Health and Public Awareness Grant
Hassan Dashti, PhD, RD
Massachusetts General Hospital and Oley Foundation
Key Project Outcome
This grant successfully addressed the significant issue of sleep disruption in consumers of home parenteral nutrition (HPN), the intravenous infusion of medical nutrition solutions overnight. Led by a multidisciplinary team of clinicians, researchers, and patients, the project applied a community-based participatory research approach to develop the first tailored sleep resources specifically for HPN consumers.
The process began with a comprehensive review of existing sleep recommendations to evaluate their relevance for HPN consumers. Focus groups with nine HPN consumers and eleven clinicians were then conducted to understand the lived experiences of sleep challenges associated with HPN. Insights from these discussions, along with findings from the literature review, informed the initial draft of recommendations. This draft was further refined with input from ten additional community members, ensuring the guidance was practical, relevant, and effective.
The final set of 36 recommendations addressed both general sleep hygiene principles, such as maintaining a consistent sleep schedule and reducing screen time before bed, and specific challenges unique to HPN users. These included strategies for minimizing disruptions caused by pump alarms, managing frequent nighttime urination, adjusting infusion schedules, and creating a safe and clutter-free sleep environment. A sleep diary was also created to help consumers track sleep patterns and collaborate with their healthcare teams on managing sleep-related issues.
These resources were translated into English and Spanish and made freely accessible online. They were also presented at the Oley and ASPEN conferences and published in peer-reviewed journals to ensure broad dissemination. The initiative has already empowered HPN consumers with practical tools to improve their sleep and has raised awareness among clinicians of the importance of tailored sleep interventions for this population.