The Impact of Non-Pharmacological Sleep Interventions on Delirium Prevention and Sleep Improvement in Postoperative ICU Patients: A Systematic Review and Network Meta-Analysis.

OBJECTIVES

Analyze the effectiveness of different non-pharmacological sleep interventions in preventing delirium among postoperative ICU patients.

RESEARCH METHODOLOGY

We conducted a comprehensive search on PubMed, Cochrane Library, Web of Science, Embase, CINAHL, OpenGrey and reference lists up to May 2024.

SETTING

We systematically searched all randomized controlled trials related to non-pharmacological sleep interventions for the prevention of delirium.

RESULTS

The results of the network meta-analysis showed that, compared to Usual Care, multicomponent interventions are the most effective measures for preventing delirium in postoperative ICU patients (RR = 0.32, 95 % CI = 0.20 to 0.51). This is followed by non-pharmacological sleep interventions aimed at stress relief (RR = 0.60, 95 % CI = 0.41 to 0.89) and circadian rhythm (RR = 0.61, 95 % CI = 0.39 to 0.96). Additionally, non-pharmacological sleep interventions focusing on circadian rhythm demonstrated an improvement in sleep quality among postoperative ICU patients (SMD = -0.99, 95 % CI = -1.88 to -0.11).

CONCLUSIONS

Our study found that multicomponent non-pharmacological sleep interventions are effective in reducing the incidence of delirium in postoperative ICU patients. Furthermore, non-pharmacological interventions focused on circadian rhythm regulation significantly enhance sleep quality among these patients.

IMPLICATIONS FOR CLINICAL PRACTICE

Based on this study, intensive care units and nursing staff have an opportunity to implement the most effective non-pharmacological sleep interventions to prevent delirium and improve sleep quality in postoperative ICU patients. This could contribute to a reduction in the incidence of delirium in postoperative ICU patients.