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Interventions to improve inpatients' sleep quality in intensive care units and acute wards: a literature review

09 July 2020
Volume 29 · Issue 13



Sleep is essential for the physical and psychological restoration of inpatients, and lack of sleep results in sleep deprivation and poor sleep quality, with potentially harmful consequences.


To summarise sleep-promoting interventions in the Intensive care unit (ICU) and acute ward setting.

Method and results:

Six databases were searched to obtain studies for review and eight studies were selected, appraised, analysed and produced two themes: sleep-disturbing factors and sleep-promoting strategies. Sleep-disturbing factors included environmental factors (such as light and noise), illness-related factors (such as pain, anxiety and discomfort), clinical care and diagnostics. Sleep-promoting strategies included using pharmacological aids (medication) and non-pharmacological aids (reducing noise and disturbances, eye masks, earplugs and educational and behavioural changes).


The literature review showed that both ICU and acute ward settings affect patients' sleep and both use similar strategies to improve this. Nevertheless, noise and sleep disturbances remain the most critical sleep-inhibiting factors in both settings. The review recommended future research should focus on behavioural changes among health professionals to reduce noise and improve patients' sleep.

Sleep is essential for physical and psychological restoration in all patients (Aitken et al, 2017). Reduced and disturbed sleep leads to a state of sleep deprivation. Sleep deprivation prevents growth hormone secretion and weakens the immune system and is associated with a delay in the healing process (Ganz, 2012; Zakri, 2019) and potentially results in an increased vulnerability to infection (D'Souza et al, 2019).

One of the ways of encouraging a good night's sleep and therefore reducing patients' vulnerability to infection in hospital is by creating quieter wards and fewer disturbances from health professionals. However, to date, there is lack of consensus on the most effective strategy for different care settings. The majority of research has been focused on sleep-promotion strategies to improve patients' sleep in the intensive care unit (ICU) and only a few studies focus on acute ward settings. In this article an acute ward is defined as a non-critical, non-intensive medical or surgical ward.

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