Poor Sleep Burden and Risk of Delirium During Hospitalisation

Pavankumar Kamat


October 11, 2021


  • Participants with moderate to severe poor sleep burden were at an increased risk of incident delirium during hospitalisation compared with those with none/minimal burden.

Why this matters

  • Findings provide the basis for a better understanding of sleep and delirium, particularly before the age of 65 years, when there is a potential window for intervention.

Study design

  • This study included 321,818 participants from the UK Biobank who reported sleep traits which were combined into a sleep burden score (0-9).

  • New-onset delirium was determined from hospitalisation records during the 12-year median follow-up.

  • 42,291 participants had sleep assessment and ≥1 subsequent hospitalisation episode after baseline and repeat assessments.

  • Funding: National Institutes of Health and others.

Key results

  • Overall, 4775 participants developed incident delirium during the median follow-up of 12 years (range, 2 months-15 years).

  • The moderate poor sleep burden group (aggregate scores, 4-5; adjusted HR [aHR], 1.18; 95% CI, 1.08-1.28; P=.002) and severe poor sleep burden group (aggregate scores, 6-9; aHR, 1.57; 95% CI, 1.38-1.80; P<.001) had an increased risk of incident delirium.

  • Risks of moderate and severe poor sleep burdens were equivalent to an additional 1.3 and 3.4 years of ageing, or 0.7 and 1.8 points increased cardiovascular disease risk score, respectively.

  • After further controlling for a participant’s baseline sleep score and time-lag, an increase in the sleep burden score of ≥2 during repeat assessment was associated with a higher risk of incident delirium (aHR, 1.79; 95% CI, 1.23-2.62; P=.002).

  • At the time of sleep assessment, participants aged <65 years with moderate/severe poor sleep burden had more than double the risk of incident delirium (aHR, 2.15; 95% CI, 1.93-2.38) vs those aged ≥65 years (aHR, 1.41; 95% CI, 1.28-1.56; P<.001 for both).


  • Observational design.


Ulsa MC, Zheng X, Li P, Gaba A, Wong PM, Saxena R, Scheer F, Rutter M, Akeju O, Hu K, Gao L. Association of poor sleep burden in middle age and older adults with risk for delirium during hospitalization. J Gerontol A Biol Sci Med Sci. 2021 Sep 24 [Epub ahead of print]. doi: 10.1093/gerona/glab272. PMID: 34558609.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: