The Effect of Nursing Interventions on Sleep Disorders in Patients Admitted to Intensive Care Units: A Systematic Review

Sleep disorders in patients in Intensive Care Units (ICUs) are one of the most important causes of increased length of stay, decreased recovery, delirium and neurological and psychological problems. Nursing interventions can be effective in improving sleep disorders. The purpose of this systematic review is to determine the effect of nursing interventions on the improvement of sleep disorders in patients admitted to ICUs.

This systematic review was conducted in the first half of 2021 by searching Persian and English articles in the period from the beginning of 1980 to the first half of 2021. The search strategy and keywords were defined based on the PICO system and inclusion criteria. Search with a combination of Persian keywords: "sleep disorder", "nursing care", "intensive care unit" and their English equivalents sleep disorder, hyper somnolence, insomnia, dyssomnia, sleep apnea, sleep deprivation, intensive care, critical care, ICU, CCU, nursing intervention nursing care in Persian-language databases Scientific Jihad (SID) and information of national publications (Magiran) and English Scopus, Web of Science, Pub Med, Science Direct and Proquest also performed using Google scholar search engine Has been. Qualitative evaluation of articles was performed with Jadad scale. Of the 18,799 initially retrieved studies, 97 reached the final review stage.

The results showed that reducing ambient noise, leisure time protocol, use of ear and eyeglasses, music therapy, aromatherapy and pharmacotherapy, especially oral melatonin, had the greatest effect on the quality and quantity of sleep. Interventions with less impact and application included massage, acupuncture, physiotherapy, milk and honey combination before bed, cognitive-behavioral therapy, spiritual care, follow-up care model, ventilator modes, relaxation and guided visualization. Also, a variety of pharmacological interventions are used as an alternative or in combination with non-pharmacological interventions.

The findings of this study showed that simple and low-cost interventions such as reducing the number of direct care visits, reducing noise and ambient light and using blindfolds and earplugs are the most effective nursing interventions in improving the quality and quantity of sleep in ICUs. After recognizing the cases that cause sleep disorders in patients admitted to ICUs, nurses can prevent the occurrence of complications of sleep disorders in patients with these interventions.