Effect of Nighttime Earplugs and Eye Masks on Sleep Quality in Intensive Care Unit Patients

JOURNAL TITLE: Indian Journal of Critical Care Medicine

1. Naricha Chirakalwasan
2. Dittapol Muntham
3. Sirimon Reutrakul
4. Pureepat Arttawejkul
Publishing Year
Author Affiliations
1. com.mps.common.model.Contributor@26fb8ce6 ,
2. com.mps.common.model.Contributor@1ac56179 ,
3. com.mps.common.model.Contributor@a35d629 ,
4. com.mps.common.model.Contributor@30114ed0
Article keywords
Delirium, Earplugs, Eye masks, Intensive care unit, Light and noise control, Sleep quality


Purpose: Poor sleep quality in intensive care unit (ICU) can be associated with poor outcome. Excessive noise and lights in ICU are known to disrupt patients’ sleep by causing arousals. Study design: A prospective randomized controlled study. Materials and methods: The patients admitted to the medical ICU were prospectively included and randomized to receive earplugs and eye masks or no intervention during their first 5 nights in ICU. Their arousal index and other sleep parameters were measured during the first night by polysomnography. Secondary outcomes including wrist actigraphy profiles and subjective sleep quality were recorded during all study nights. Results: Seventeen patients were enrolled. Eight patients were randomized to earplugs and eye masks group and nine patients were randomized to control group during their first 5 nights in the ICU. The use of earplugs and eye masks demonstrated the trend toward lower arousal index during the first night (21.15 (14.60) vs 42.10 (18.20) events per hour, p = 0.086) and increased activity index (activity count/hour) (16.12 (7.99) vs 10.84 (10.39) count/hour, p = 0.059) compared to control group. Polysomnography and actigraphy did not demonstrate good agreement. Conclusion: The use of earplugs and eye masks has a trend toward reduction in arousal index and increased activity in patients admitted to ICU. Limited sample size most likely explained insignificant difference in outcomes. Wrist actigraphy did not accurately measure sleep parameters in ICU patients. Trial registration: www.clinicaltrials.in.th, TCTR20170727003.

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