Sleep Medicine Division, the First People's Hospital of Yunnan Province, Kunming City, China.
Endocrinology Department, Children's Hospital of Kunming, Kunming City, China.
Medicine (Baltimore). 2023 Dec 29;102(52):e36298. doi: 10.1097/MD.0000000000036298.
Critically ill patients in intensive care often struggle with disrupted sleep, a prevalent issue in this population. However, the question of which non-pharmacological intervention is most effective in enhancing sleep quality remains unanswered. This study was conducted to comprehensively evaluate and compare the efficacy of various non-pharmacological interventions aimed at improving sleep quality among critically ill individuals.
We conducted a search of PubMed, Embase, and the Cochrane Library (Cochrane Central Register of Controlled Trials) without language restrictions to identify articles published until July 15, 2023. Randomized controlled trials (RCTs) that investigated various nursing interventions designed to improve sleep quality in critically ill patients were included in this network meta-analysis. All analyses were performed using R software (version 3.4.3) with the "gemtc" package.
A total of 2036 patients from 31 RCTs were included in the network meta-analysis, involving 11 different nursing interventions (routine care, relaxation combined with imagery (RI), nursel, music + earplugs + eye masks, music, eye masks, earplugs + eye masks, earplugs, aromatherapy, Warm footbath combined with acupoint exercise (WFA), Virtual reality meditation (VR)). Eye masks and earplugs + eye masks were associated with improved sleep quality compared to routine care intervention (P < .05).
In summary, eye masks and earplugs + eye masks stand out as the most effective interventions for enhancing sleep quality in critically ill patients. Therefore, critical care nurses should consider incorporating the use of eye masks alone or combining music with eye masks into the sleep care regimen for critically ill patients.
重症监护病房的危重症患者经常饱受睡眠紊乱之苦，这在该人群中是一个普遍存在的问题。然而，哪种非药物干预措施最能有效提高睡眠质量的问题仍未得到解答。本研究旨在全面评估和比较各种旨在提高危重症个体睡眠质量的非药物干预措施的疗效。
我们对 PubMed、Embase 和 Cochrane 图书馆（Cochrane 中央对照试验注册库）进行了无语言限制的检索，以确定截至 2023 年 7 月 15 日发表的文章。本网络荟萃分析纳入了旨在改善危重症患者睡眠质量的各种护理干预的随机对照试验（RCT）。所有分析均使用 R 软件（版本 3.4.3）和“gemtc”包进行。
共有来自 31 项 RCT 的 2036 名患者纳入网络荟萃分析，涉及 11 种不同的护理干预（常规护理、放松联合意象（RI）、Nursel、音乐+耳塞+眼罩、音乐、眼罩、耳塞+眼罩、耳塞、芳香疗法、温水足浴联合穴位运动（WFA）、虚拟现实冥想（VR））。与常规护理干预相比，眼罩和耳塞+眼罩与改善睡眠质量相关（P<0.05）。
总之，眼罩和耳塞+眼罩是提高危重症患者睡眠质量最有效的干预措施。因此，重症监护护士应考虑将眼罩单独使用或在音乐治疗中结合眼罩纳入危重症患者的睡眠护理方案。
