Sleep‐disrupting effects of nocturnal nursing interventions in intensive care unit patients: A systematic review

Abstract

Patients staying in the intensive care unit (ICU) require constant monitoring and numerous nursing interventions performed as needed, irrespective of daytime or night‐time. The disturbing effect of nocturnal nursing interventions and their contribution to sleep disruptions are unclear. The review analysed nocturnal nursing interventions, and their character, frequency and effects on sleep quality. The databases CINAHL, PubMed and Scopus were searched to identify and subsequently evaluate 19 studies (1,531 patients) meeting the algorithm used. Although nocturnal nursing interventions provided to ICU patients were frequent and varied, they were responsible for only a minority of observed sleep disruptions. The most frequent nocturnal intervention was Vital signs monitoring (Nursing Interventions Classification, 6,680). Implementation of sleep protocols, of which an integral part is clustering and planning of nocturnal interventions, appears to be effective. The review suggests that nursing interventions are not the main cause of sleep disruptions in the ICU. In an effort to improve the quality of sleep in ICU patients, other factors causing disturbance need to be addressed as well. The current trend is more careful planning of nursing care, clustering of interventions and minimizing nocturnal disruptions to allow patients at least one uninterrupted sleep cycle (90 min).

Recent Progress in Long-Term Sleep Monitoring Technology

“…For example, in the intensive care unit (ICU), where special care of the patient is required, very comprehensive monitoring is performed. Methods for assessing and monitoring sleep in the ICU include polysomnography, bispectral indices, behavior charts, nursing assessments, and patient questionnaires [ 24 ]. However, technology that allows for long-term sleep detection at home is still necessary.…”

An aromatherapy massage intervention on sleep in the ICU: A randomized controlled feasibility study

“…Many patients experience significant issues with sleep in the ICU, which can lead to adverse consequences, including delirium, cognitive impairment and protracted recovery. The causes for this are multi‐factorial and the effects are deleterious, impacting on patients' recovery from ICU from intra‐ICU to post‐discharge 1–4 . Massage to enhance onset and quality of sleep is one solution put forward in the literature, although little evidence on efficacy exists 1,5,6 .…”

“…ery from ICU from intra-ICU to post-discharge. [1][2][3][4] Massage to enhance onset and quality of sleep is one solution put forward in the literature, although little evidence on efficacy exists. 1,5,6 Several small studies indicate aromatherapy Inhalation or massage improved selfreported sleep quality in patients being treated for heart disease, cardiac ICU or percutaneous coronary interventions in ICU.…”

Systematic reviews and meta‐analyses: Sleep in the intensive care unit and near wind turbines

“…Locihová et al (2021) investigated the sleep‐disrupting effects of nocturnal nursing interventions in intensive care unit patients (ICU‐P). This is a highly important issue, because we all know that the environment of the ICU, although life‐saving, nevertheless is not sleep friendly.…”