Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study

Nov 22, 2017Critical care (London, England)

Earplugs and eye masks may improve sleep in critically ill patients

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Abstract

In the intervention group, the duration of N3 sleep was 74 minutes compared to 31 minutes in the control group.

The proportion of N3 sleep was 21% in the intervention group and 11% in the control group, which approached statistical significance.
Patients who wore earplugs all night experienced a longer duration of N3 sleep compared to those in the control group.
The intervention group had fewer prolonged awakenings, averaging 21 compared to 31 in the control group.
Overall clinical outcome variables showed no significant differences between the two groups.

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BACKGROUND: Poor sleep is common in intensive care unit (ICU) patients, where environmental factors contribute to reduce and fragment sleep. The objective of this study was to evaluate the impact of earplugs and eye mask on sleep architecture in ICU patients.

METHODS: A single-center randomized controlled trial of 64 ICU patients was conducted from July 2012 to December 2013. Patients were randomly assigned to sleep with or without earplugs and an eye mask from inclusion until ICU discharge. Polysomnography was performed on the first day and night following inclusion. The primary outcome was the proportion of stage N3 sleep over total sleep time. Secondary outcomes were other descriptors of sleep and major outcome variables.

RESULTS: In the intervention group, nine (30%) patients did not wear earplugs all night long. The proportion of N3 sleep was 21 [7-28]% in the intervention group and 11 [3-23]% in the control group (p = 0.09). The duration of N3 sleep was higher among the patients in the intervention group who wore earplugs all night long than in the control group (74 [32-106] vs. 31 [7-76] minutes, p = 0.039). The number of prolonged awakenings was smaller in the intervention group (21 [19-26] vs. 31 [21-47] in the control group, p = 0.02). No significant difference was observed between the two groups in terms of clinical outcome variables.

CONCLUSIONS: Earplugs and eye mask reduce long awakenings and increase N3 duration when they are well tolerated.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT02292134 . Registered on 21 Nov 2013.

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Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study

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