Sleep Quality Among Burn Survivors and the Importance of Intervention: A Systematic Review and Meta-Analysis.

Abstract

Burn survivors undergo a plethora of physiologic disturbances that can greatly affect the quality of life (QOL) and healing processes. This review aimed to systematically examine sleep quality among individuals with burns and to explore the effectiveness of interventions using a meta-analytic approach. A systematic review of the literature was conducted by searching for articles using various databases. Titles and abstracts were screened and full texts of retained articles were assessed based on eligibility criteria. Methodological quality was ascertained in all articles using various scales. Overall, 5323 articles were screened according to titles and abstracts and 25 articles were retained following full-text screening. Of the 25 articles, 17 were assessed qualitatively, while 8 were included in the meta-analysis. Based on the qualitative analysis, sleep was found to be negatively affected in patients with burn injuries. The subsample of eight articles included in the meta-analysis showed an overall weighted mean effect size (Hedges's g) of 1.04 (SE = 0.4, 95% CI, z = 3.0; P < 0.01), indicating a large, positive effect of the intervention on sleep quality for patients with burn injuries. This review was able to demonstrate the detrimental effects of burn injury on sleep quality. Several interventions have been examined throughout the literature and have shown to be beneficial for sleep quality. However, there is great heterogeneity between existing interventions. The results from this review suggest that further research is needed before recommendations can be made as to which intervention is most effective at improving sleep in patients suffering from burn injuries.