{
  "abstract": "BackgroundLength of stay (LOS) in acute psychiatric inpatient settings is clinically and operationally impo rtant, but practical early markers for identifying patients at risk for prolonged hospitalizatio n remain limited.\n\nObjectiveTo evaluate whether sleep instability measured during the early inpatient observation period was associated with prolonged post-enrollment hospitalization in acute psychiatric inpat ients.\n\nMethodsThis observational study included 94 consecutive patients admitted to an acute psychiatric inpat ient unit. Monitoring began after study enrollment, and participants contributed 5 to 7 available nightly observations from wrist actigraphy and routine nursing observation; observations were not required to occur on consecutive calendar days. The primary exposure was intraindividual sleep variability (IIS V), defined as the within-subjec t standard deviation of nightly total sleep time across available post-enrollment observations. The primary outcome was prolonged post-enrollment length of stay, defined using the 75th percentile of the cohort distribution. Age- and sex-adjusted logistic regression models evaluated associations, discrimination, calibration, and risk stratification. Total length of stay from admission was examined as a temporally distinct sen sitivity estimand.\n\nSleep instability measured during the early inpatient observation period, derived independently from wearable actigraphy and from routine nursing sleep documentation, was associated with prolonged post-enrollment hospitalization. Because the outcome interval overlaps the period during which the sleep observations were accumulated, these findings describe an association across the early inpatient course rather than a prediction made at enrollment. The results support further evaluation of repeated sleep variability as a longitudinal inpatient measure; the variable observation schedule, single-center sample, and absence of external validation mean that clinical implementation remains premature.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "H.-M. Chen"
    },
    {
      "name": "Y.-L. Chen"
    },
    {
      "name": "V. C.-H. Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "C. C.-H. Yang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5cdn18key4dam.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.08.26362319",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.08.26362319v1.full",
  "id": "5cdn18key4dam",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.08.26362319v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ],
    [
      "openalex",
      "3205|Sleep and related disorders"
    ]
  ],
  "openalex": "W7212385459",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.08.26362319v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5cdn18key4dam.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:23Z",
      "native_id": "10.64898/2026.09.08.26362319",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.08.26362319v2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Sleep Variability From Routine Nursing Observation and Wearable Actigraphy for Early Risk Stratification in Acute Psychiatric Inpatients: Prospective Observational Study",
  "title_text": "Sleep Variability From Routine Nursing Observation and Wearable Actigraphy for Early Risk Stratification in Acute Psychiatric Inpatients: Prospective Observational Study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:56Z",
  "url": "https://research.draconitic.com/paper/5cdn18key4dam",
  "venue": "medRxiv",
  "versions": []
}