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Delirium sleep disturbance — DGM MCQ

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ModerateDeliriumDelirium sleep disturbanceDGM

An 83-year-old man with delirium is more confused overnight on a noisy ward bay. He naps for long periods during the day and receives observations every hour despite being stable. No untreated infection, pain or retention is found. Current medicines include ramipril and paracetamol. What is the most appropriate management?

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Correct answer: A — Promote sleep hygiene and reduce avoidable night-time disruption

Sleep disturbance worsens delirium, and non-pharmacological sleep hygiene with reduced avoidable disruption is appropriate. Diazepam, repeated moves, daytime immobility and overnight noise can worsen delirium. Ward routines are part of delirium prevention and treatment.

Reference: NICE CG103