Arttawejkul Pureepat, Reutrakul Sirimon, Muntham Dittapol, Chirakalwasan Naricha
Department of Medicine, Division of Pulmonary and Critical Care Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, Illinois, USA.
Indian J Crit Care Med. 2020 Jan;24(1):6-10. doi: 10.5005/jp-journals-10071-23321.
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.
A prospective randomized controlled study.
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.
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.
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.
www.clinicaltrials.in.th, TCTR20170727003.
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.
重症监护病房（ICU）睡眠质量差可能与不良预后相关。已知ICU中过多的噪音和光线会通过引起觉醒干扰患者睡眠。
一项前瞻性随机对照研究。
前瞻性纳入入住内科ICU的患者，并随机分为在ICU的前5个晚上接受耳塞和眼罩或不接受干预两组。在第一个晚上通过多导睡眠图测量其觉醒指数和其他睡眠参数。在所有研究夜晚记录包括腕部活动记录仪记录情况和主观睡眠质量在内的次要结局。
共纳入17例患者。8例患者在ICU的前5个晚上被随机分配到耳塞和眼罩组，9例患者被随机分配到对照组。与对照组相比，使用耳塞和眼罩在第一个晚上显示出觉醒指数降低的趋势（每小时21.15（14.60）次事件对42.10（18.20）次事件，P = 0.086）以及活动指数（每小时活动计数）增加（16.12（7.99）次计数/小时对10.84（10.39）次计数/小时，P = 0.059）。多导睡眠图和活动记录仪记录情况的一致性不佳。
对于入住ICU的患者，使用耳塞和眼罩有降低觉醒指数和增加活动的趋势。样本量有限很可能解释了结局无显著差异的原因。腕部活动记录仪不能准确测量ICU患者的睡眠参数。
www.clinicaltrials.in.th，TCTR20170727003。
Arttawejkul P, Reutrakul S, Muntham D, Chirakalwasan N. 夜间耳塞和眼罩对重症监护病房患者睡眠质量的影响。《印度重症监护医学杂志》2020；24(1):6 - 10。
