Effect of nighttime earplugs and eye mask on sleep quality in medical intensive care unit patients

Abstract

Background: Excessive noise and light in medical intensive care unit are known to disrupt patient’s sleep by causing arousals which can lead to poor sleep quality. Aim and Objectives: To determine the efficacy of the use of earplugs and eye mask to improve sleep quality in ICU patients. Methods: 15 medical ICU patients were randomized to sleep with or without earplugs and eye mask during their first five nights. Seven patients were in the intervention group and 8 patients were in the control group. Arousal index and other sleep parameters were measured during the first night in ICU using attended polysomnography. Wrist actigraphy and Richard-Campbell sleep questionnaire were utilized to determine daytime activity and sleep quality during all study nights, respectively. Correlation between actigraphy and polysomnography measurements of sleep data were compared. Results: The use of earplugs and eye mask during the first night was associated with a trend towards lower arousal index compared to control (29.05 (23.71) vs 35.34 (18.86) events per hour, p=0.197), improvement in sleep quality (59.17 (5.98) vs 56.5 (5.23), p= 0.185) and higher daytime activity in the intervention group compared to the control group (7806 [7003] vs 1556 [3889] counts, p =0.067). Wrist actigraphy and polysomnography data demonstrated only fair agreement in all sleep parameters. Conclusion: The use of earplugs and eye mask in medical ICU patients demonstrated a trend towards reduction in arousal index and improvement in sleep quality and daytime activity. Wrist actigraphy did not accurately measure sleep parameters in ICU patients.