Improving Sleep for Older Adults in the Emergency Department

What this study involves

The registry says this study is recruiting. Individual locations may have different availability.

Study type

Observational

Phase

Not applicable / not listed

Age range

70 years - Not specified

Sex eligible

All sexes

Healthy volunteers

Not accepted

Participants

78 Estimated

These are starting points, not an eligibility decision. The research team must review the full requirements.

About the research

This quality improvement project aims to improve sleep for older adults during overnight stays in the Emergency Department. Older adults in the ED may experience prolonged stays while awaiting inpatient admission, and this period can involve sleep disruption, immobility, delirium risk, and physiologic stress. The first phase of the project will measure baseline sleep duration and related physiologic patterns among adults aged 70 years or older who are staying overnight in the ED and are admitted, or likely to be admitted, to Medicine.

Participants will be invited to wear a Fitbit Sense 2 device for approximately 24 hours. The device will collect sleep, heart rate, and activity data. Additional information will be collected through patient questionnaires and Epic chart review, including clinical and environmental factors that may affect sleep, such as ED location, overnight vital signs, bloodwork, imaging, medications, interventions, and delirium documentation. Fitbit data will be analyzed in aggregate and will not be used to guide real-time clinical care or flow into Epic.

After baseline sleep patterns and associated factors are better understood, the project will use quality improvement methods, including Plan-Do-Study-Act cycles, to introduce and evaluate practical sleep-improvement strategies through the Seniors Emergency Medicine Centre. Potential interventions may include reducing noise and lighting when clinically appropriate, providing sleep-support items such as earplugs and eye masks, using white noise, improving equipment and alarm management where safe, and considering sleep-promoting medications such as melatonin when appropriate. The primary outcome is total sleep time during the overnight ED stay, measured using Fitbit data. Secondary and balancing measures include patient satisfaction with wearing the Fitbit, delirium episodes, care delays related to sleep interventions, and staff feedback about workflow or device-related disruptions.

This project is intended to inform local improvements in care processes for older adults in the UHN Emergency Department and to support safer, more patient-centered overnight ED care. The QIRC submission identifies the project as a UHN quality improvement project focused on process change, information gathering, and evaluation, with an aim to improve overnight total sleep time for older adults by approximately one hour over six months after baseline measurement.

Who may be able to participate?

The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.

Inclusion Criteria:

• Adults aged 70 years or older.
• Patient is in the Emergency Department at Toronto General Hospital or Toronto Western Hospital.
• Patient is admitted, or likely to be admitted, to the General Internal Medicine service.
• Patient is expected to remain in the Emergency Department overnight.
• Patient is able and willing to wear a wrist-worn wearable monitoring device for approximately 24 hours.
• Patient provides consent to participate in the quality improvement project.

Exclusion Criteria:

• Patient declines or is unable to provide consent.
• Patient is unable to wear the wearable device safely or comfortably.
• Patient has a clinical condition or care requirement that makes wearable monitoring inappropriate, as determined by the clinical or project team.
• Patient is expected to leave the Emergency Department before overnight monitoring can occur.

Study population

Adults aged 70 years or older who are staying overnight in the Emergency Department at University Health Network and are admitted, or likely to be admitted, to the General Internal Medicine service. Participants will be invited to wear a wrist-worn wearable device to measure sleep, heart rate, and activity during the Emergency Department stay.

Treatment, groups and participation

The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.

Assignment

Not reported

Masking

Not reported

What researchers are measuring

Outcome measures describe what is being studied. They are not proof that a treatment works.

Primary measures

Secondary measures

Research locations (2)

The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.

2 locations

Study team and timeline

Lead sponsor

University Health Network, Toronto

Study start

Apr 1, 2026 Actual

Primary completion

Dec 31, 2028 Estimated

Study completion

Dec 31, 2028 Estimated

First posted

Nov 10, 2026 Actual

Last updated

Nov 10, 2026 Actual

Official study contacts

No central contact is listed. Check the locations and the official record.