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Non-pharmacological sleep interventions for adult patients in intensive care Units: A systematic review
Institution:1. Department of Pediatrics, Division of Pediatric Critical Care, Duke University School of Nursing, Duke University School of Medicine, Duke Institute for Brain Sciences 307 Trent Drive, Durham, NC 27710, USA;2. Duke University School of Nursing, 307 Trent Drive, Durham, NC 27701, USA;3. Indiana University Health Methodist Hospital, 1701 North Senate Avenue, Indianapolis, IN 46202, USA;4. Vidant Medical Center, 2100 Stantonsburg Road, Greenville, NC 27834, USA;1. Enfermera Coordinadora de Trasplantes Nacional, Organización Nacional de Trasplantes, España;2. Profesora Escuela Universitaria de Enfermería de Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España;1. Department of Pharmacy, AdventHealth Orlando, 601 East Rollins Street, Orlando, FL 32803, USA;2. Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA;3. Department of Nursing, AdventHealth Orlando, 601 East Rollins Street, Orlando, FL 32803, USA;4. Department of Surgery, AdventHealth Orlando, 601 East Rollins Street, Orlando, FL 32803, USA;5. Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA
Abstract:ObjectivesTo synthesize and evaluate current non-pharmacological sleep interventions for critically ill adult patients in intensive care units and provide recommendations for future studies of non-pharmacological means of improving this population’s sleep quality.Research Methodology/DesignThe literature search was conducted following PRISMA guidelines. Seven databases CINAHL, PsycINFO, Embase, Medline, Cochrane Library, Web of Science, and Scopus and three keywords, sleep, intervention and intensive care unit were employed. All possible combinations of the keywords and similar words were considered. Included studies were primary studies, involved adult intensive care unit patients, focused on non-pharmacological sleep interventions, measured subjective and/or objective sleep quality and were published in English between January 2010 and September 2020.ResultsThe 20 included studies examined different types of non-pharmacological sleep interventions involving use of earplugs, an eye mask, white noise, music, aromatherapy, massage, acupressure, light intensity, a sleep hygiene protocol, quiet time and minimization of nursing care. Of 18 studies employing an experimental design, most reported that non-pharmacological interventions improved sleep quality. All these interventions involved environmental factors or complementary relaxation strategies.ConclusionsNon-pharmacological sleep interventions can have a positive influence on sleep quality in critically ill patients, but more research is needed to determine their effectiveness.
Keywords:Critically ill patient  Intensive care unit  Sleep quality  Non-pharmacological sleep intervention  Systematic review
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