Effect of earplug/eye mask on sleep and delirium in intensive care patients

Abstract

Background: Environmental factors such as loud sounds and bright lights in intensive care units can cause sleep disorders and delirium.Aim: The present study aims to investigate the effects of the overnight use of earplugs and eye masks by intensive care patients on their sleep quality and the degree of delirium.Study Design: This randomized controlled experimental study was conducted on the patients admitted to a coronary intensive care unit. Methods:The patients in the experimental group used earplugs and eye masks during the night, while those in the control group received only routine care. Data were collected using an information form, the Richards-Campbell sleep questionnaire (RCSQ), and the intensive care delirium screening checklist (ICDSC). Results:The study included a total of 84 patients, 42 in the experimental group and 42 in the control group. The baseline average score of the patients in the experiment group on the RCSQ was 40.11 ± 16.55, with a Time 1 average score of 64.09 ± 14.07 and a Time 2 average score of 72.07 ± 11.75; their baseline average score on the ICDSC was 0.47 ± 0.50, with a Time 1 average score of 0.33 ± 065 and a Time 2 average score of 0.19 ± 039. The baseline average score of the patients in the control group on the RCSQ was 44.07 ± 7.30, with a Time 1 average score of 46.97 ± 9.22 and a Time 2 average score of 47.04 ± 11.53; the baseline average score of the control group on the ICDSC was 0.42 ± 0.50, with a Time 1 average score of 0.50 ± 0.70 and a Time 2 average score of 0.57 ± 0.66. A statistically significant difference was found between the Time 1 and Time 2 average scores of the experimental and control groups on the RCSQ and between the Time 2 average scores of the experimental and control groups on the ICDSC (U = 198.00, P < .001; U = 70.000, P < .001; U = 614.000, P = Á004 respectively). Conclusions:The earplugs and eye masks used by the intensive care patients overnight were associated with an increase in sleep quality and a decrease in the degree of delirium.Relevance to Clinical Practice: The use of earplugs and eye masks is recommended for intensive care units in supporting sleep quality and preventing delirium.

Effect of Implementing Nursing Interventions Bundle on Sleep Quality and Associated Delirium among Patients at Intensive Care Unit

“…While fifty percent of the intervention group had good sleep quality compared to control group. Also, Akpinar R et al, (2022) (34) emphasized this result. As regard incidence of ICU acquired delirium, the present finding revealed a minority sample of the study group that had delirium compared with the control group.…”

Effect of using eye masks and earplugs in preventing delirium in intensive care patients: A single‐blinded, randomized, controlled trial

“…In studies, it is seen that the education levels are equal, along with other factors, between the intervention and control groups. 17,20,23,32,33 According to the results of the study, the high level of education of the intervention group and the lower incidence of delirium compared with the control group suggest that they use eye masks and earplugs per instructed and that the level of education may have an effect on the delirium.…”

“…34 In A randomized controlled study by Akpınar et al reported that while the use of earplugs and eye masks during the night decreased the perceived noise level of the patients, it also increased their sleep quality and reduced the degree of delirium. 32 Additionally, a recent metaanalysis highlighted that the use of earplugs and eye masks was associated with a significant reduction in the incidence of delirium. 21 Systematic review study by Polat et al earplugs and eye masks were found to have potential positive effects on sleep quality and delirium incidence.…”

Spotlight on Randomised Controlled Trials

“…As patients were randomized, trial registration is still essential, and the authors have done this. The third RCT by Akpinar 5 randomized patients in a coronary care unit in Turkey to receive either earplugs and eye masks or usual care (neither) to determine whether they impacted the patients' sleep quality and the occurrence of delirium. The last trial in this issue, also conducted in Turkey, investigated whether abdominal massage influenced bowel evacuation in neurosurgical adult patients 6 .…”

“…The four trials in this issue, 3–6 include a pilot RCT 2 . In the first trial by Siebert et al 3 paediatric critical care staff in a Swiss tertiary hospital were randomized to either receive a face to Face or a blended learning approach to the use of a manual defibrillator.…”