A good night’s sleep is widely believed to be essential for health and recovery from illness. The various effects of sleep disruption on physical health have been well described. Experimental cohort studies performed on healthy volunteers have reported a range of adverse effects related to sleep disruption, such as susceptibility to infection and effects on respiratory function, blood pressure, thyroid function, and cortisol levels. Sleep disruption has also been associated with impaired glucose sensitivity. A small number of studies have attempted to measure the health effects of sleep disruption in the hospital environment on patients as distinct from healthy subjects in a laboratory study. Evidence suggests that consolidated sleep may have a protective effect for delirium, in contrast, pain intensity may be exacerbated by poor sleep, particularly for burn injury, and an increased risk of falling is associated with sleep disruption. Poor sleep is a common complaint among all hospitalized patients, with total sleep time either normal or reduced and poor self-reported subjective sleep quality. Sleep is disrupted and characterized by high arousal indices (mean: 5-21/h) and limited proportions of slow wave and rapid eye movement (restorative) sleep. The importance of sleep as a component in overall clinical care and recovery is not readily addressed in nursing education at both undergraduate and post-graduate levels, contributing to its deprioritization. Hospital inpatients are already vulnerable to sleep restriction and sleep disruption because of their illness and displacement from their home and usual routine. This is further exacerbated by features of the hospital environment and health care activities.

Enhancing the quality of sleep within an acute care context continues to pose a formidable clinical conundrum. Despite research that has consistently underscored the importance of addressing sleep-related challenges in hospital settings, substantive headway towards amelioration has remained elusive. Nurses are ideally positioned to be clinical leaders in the management and prioritization of sleep as a component of patient care. There remain gaps in our knowledge about sleep in acute care settings in the following areas: pragmatic sleep assessment, the effect of improving sleep on the incidence of delirium, outcomes associated with sleep, best hospital design for rest and sleep in hospital, design of interventional studies to mitigate the need for large sample sizes and potential for bias, and how to increase the priority afforded this important aspect of wellbeing in hospital.

The present Special Issue is dedicated to the examination of ongoing research endeavors to highlight nursing leadership and management aimed at augmenting the sleep experience as an integral facet of clinical care. We seek to investigate research encompassing interventions and innovative strategies for improving sleep and sleep outcomes currently under evaluation, the identification of clinical challenges and strategies to address these, and the facilitation of alignment with patients' circadian rhythms for optimal therapeutic outcomes. We also hope to highlight best hospital design for sleep and rest, raise awareness of the importance of sleep, and to provide ideas to improve the priority afforded to this vital area of well-being.

Potential topics include but are not limited to the following:

• Optimizing patient sleep in acute care
• Integrating nursing management and leadership through building design features and considerations.
• Sound level mitigation approaches that are effective at optimizing nocturnal environments
• Nursing leadership in promoting sleep as a holistic component of patient care
• The benefits and limitations of subjective sleep assessments for individualized patient care
• Novel approaches to sleep monitoring in acute care settings and what can be feasibly implemented
• The implementation of sleep bundles to enhance patient care and recovery
• Enhancing nurses’ knowledge of sleep and its role in psychological and physiological wellbeing
• Nonpharmacological interventions that enhance sleep and sleep within a hospital setting
• The risks and benefits of z-class drugs to aid sleep in acute care settings
• Management approaches to enhancing sleep in patients with delirium
• Patient and staff perception of sleep in acute care settings
• Nurses’ contribution to hospital design to enhance patient sleep and rest
• Impact of sleep disturbance on memory and cognition in acute care patients
• Development of sleep guidelines in acute care settings
• Role of melatonin in improving sleep
• Sleep content in health professionals’ education curricula