Effect of Nighttime Earplugs and Eye Masks on Sleep Quality in Intensive Care Unit Patients

Mar 10, 2020Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

How Wearing Earplugs and Eye Masks at Night May Improve Sleep in ICU Patients

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Abstract

The use of earplugs and eye masks is associated with a trend toward lower arousal index of 21.15 vs 42.10 events per hour during the first night in the ICU.

Patients receiving earplugs and eye masks experienced a lower arousal index compared to those without intervention.
An increased activity index was observed in the earplugs and eye masks group compared to the control group.
The differences in sleep parameters were not statistically significant, likely due to the limited sample size.
Wrist actigraphy did not show good agreement with polysomnography in measuring sleep parameters in ICU patients.

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PURPOSE: Poor sleep quality in intensive care unit (ICU) can be associated with poor outcome. Excessive noise and lights in ICU are known to disrupt patients' sleep by causing arousals.

STUDY DESIGN: A prospective randomized controlled study.

MATERIALS AND METHODS: The patients admitted to the medical ICU were prospectively included and randomized to receive earplugs and eye masks or no intervention during their first 5 nights in ICU. Their arousal index and other sleep parameters were measured during the first night by polysomnography. Secondary outcomes including wrist actigraphy profiles and subjective sleep quality were recorded during all study nights.

RESULTS: Seventeen patients were enrolled. Eight patients were randomized to earplugs and eye masks group and nine patients were randomized to control group during their first 5 nights in the ICU. The use of earplugs and eye masks demonstrated the trend toward lower arousal index during the first night (21.15 (14.60) vs 42.10 (18.20) events per hour,= 0.086) and increased activity index (activity count/hour) (16.12 (7.99) vs 10.84 (10.39) count/hour,= 0.059) compared to control group. Polysomnography and actigraphy did not demonstrate good agreement. p p

CONCLUSION: The use of earplugs and eye masks has a trend toward reduction in arousal index and increased activity in patients admitted to ICU. Limited sample size most likely explained insignificant difference in outcomes. Wrist actigraphy did not accurately measure sleep parameters in ICU patients.

TRIAL REGISTRATION: www.clinicaltrials.in.th, TCTR20170727003.

HOW TO CITE THIS ARTICLE: Arttawejkul P, Reutrakul S, Muntham D, Chirakalwasan N. Effect of Nighttime Earplugs and Eye Masks on Sleep Quality in Intensive Care Unit Patients. Indian J Crit Care Med 2020;24(1):6-10.

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Effect of Nighttime Earplugs and Eye Masks on Sleep Quality in Intensive Care Unit Patients

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