A Cochrane study reviewed the evidence on non-pharmacological interventions for improving sleep in critically ill adults.
Overall, the quality of the evidence for an effect of the interventions on any of the outcomes was low or very low. Normally, we would try to pool findings from similar trials of each intervention, but this was difficult because the design of the trials varied greatly. We were able to combine the results from three trials of earplugs and eye masks and found that their use increased the number of hours slept and prevented delirium in adults in the ICU. However, we cannot be certain about these findings because of problems with how the trials were carried out.
There was also some low quality evidence from four studies that music may improve subjective sleep quality and quantity, but we could not pool the data. Similarly, a low number of studies found that relaxation techniques, foot massage, acupressure, nursing or social intervention, and sound masking can provide small improvements in participant-reported or nurse-assessed sleep quality and quantity, but the quality of the evidence was low. The effects of the interventions on objective sleep outcomes (e.g., sleep measured by a machine) varied: the majority of studies that looked at the use of earplugs and eye masks found no benefit, and although the results from six trials of ventilator modes suggested that certain ventilator settings might offer benefits over others, the results of the individual trials did not always agree with each other. Only one study measured length of stay in the ICU and found no significant effect of earplugs plus eye masks. None of the included studies looked at economic outcomes, risk of post-traumatic stress disorder, or deaths.
