Efficacy of non-pharmacological interventions to improve sleep quality in ICU patients: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

JIANG Lingjie ^1,2 , YUE Weigang ³ , WANG Shengjun ¹ , HAN Lulu ¹ ,  ZHANG Zhigang ^1,3 , ZHANG Caiyun ⁴ , YAO Li ^1,2 , DING Nannan ^1,2

1. College of Nursing, Lanzhou University, Lanzhou 730000, P.R.China;
2. The First Hospital of Lanzhou University, Lanzhou 730000, P.R.China;
3. Department of Critical Care Medicine, The First Hospital of Lanzhou University, Lanzhou 730000, P.R.China;
4. Department of Nursing, The First Hospital of Lanzhou University, Lanzhou 730000, P.R.China;

Corresponding author：

ZHANG Zhigang, Email: zzg3444@163.com

Keywords：

Intensive care unit; Non-pharmacological intervention; Sleep quality; Network meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201907084

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Objectives To assess the efficacy of non-drug interventions on improving sleep quality in ICU patients by network meta-analysis.Methods The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on non-drug interventions on improving sleep quality in ICU patients from inception to December, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, network meta-analysis was performed by using the Stata 13.0 software.Results A total of 12 RCTs, involving 1 223 patients and 9 non-pharmacological interventions (music therapy, comprehensive nursing intervention, TCM emotions, music therapy+TCM emotions, Chinese medicine pillow therapy, ear acupressure, eye mask+earplugs+music, eye mask+earplugs, regular care) were included. The results of Pittsburgh sleep quality index (PSQI) showed that eye mask+earplugs, eye masks, and comprehensive nursing interventions were superior to conventional care in improving sleep quality in ICU patients, and the rankings were: eye mask+earplugs>eye mask>comprehensive nursing intervention, music therapy+TCM emotional>Chinese medicine emotional>music therapy>general care. The results of Richards-Campbell sleep scale (RCSQ) showed that eye mask+earplugs+music, Chinese medicine pillow therapy, and auricular pressure beans were superior to conventional care, and the rankings were: eye mask+earplugs+music>Chinese medicine pillow therapy>music therapy>ear acupressure beans>general care.Conclusions The evidence shows that in improving the sleep quality of ICU patients, eye mask + earplug, eye mask, comprehensive nursing intervention, music therapy + TCM emotional characteristics may all be effective intervention methods. It is suggested that more non-drug interventions should be carried out in the future for enhancing the sleep quality of ICU patients.

Citation： JIANG Lingjie, YUE Weigang, WANG Shengjun, HAN Lulu, ZHANG Zhigang, ZHANG Caiyun, YAO Li, DING Nannan. Efficacy of non-pharmacological interventions to improve sleep quality in ICU patients: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(4): 403-411. doi: 10.7507/1672-2531.201907084 Copy

1.	周瑜利, 谢国红. ICU 病人睡眠障碍的相关因素调查. 当代护士(学术版), 2011, (7): 134-136.
2.	Auger RR. Clinical sleep disorders. Philadelphia: LWW, 2012: 1010-1011.
3.	Hauri PJ. Can we mix behavioral therapy with hypnotics when treating insomniacs? Sleep, 1997, 20(12): 1111-1118.
4.	刘爱萍, 李伦, 赵晔, 等. 当归多糖抗辐射效果的网状 Meta 分析. 中国药物评价, 2014, 31(2): 107-112.
5.	Cope S, Jansen JP. Quantitative summaries of treatment effect estimates obtained with network meta-analysis of survival curves to inform decision-making. BMC Med Res Methodol, 2013, 13: 147.
6.	Salanti G, Dias S, Welton NJ, et al. Evaluating novel agent effects in multiple-treatments meta-regression. Stat Med, 2010, 29(23): 2369-2383.
7.	Hansen IP, Langhorn L, Dreyer P. Effects of music during daytime rest in the intensive care unit. Nurs Crit Care, 2018, 23(4): 207-213.
8.	张清, 姚小红, 汪海芹. 护理干预对 ICU 清醒患者不良情绪和睡眠质量的影响探析. 中国实用医药, 2017, 12(8): 169-171.
9.	王琳. 个性化音乐疗法结合中医情志护理对 ICU 患者心理和睡眠情况的影响. 齐鲁护理杂志, 2018, 24(15): 111-113.
10.	陈鸿. 护理干预对 ICU 患者术后睡眠质量的影响. 中国初级卫生保健, 2009, 23(10): 123-124.
11.	佘克蓉. 护理干预对 ICU 患者睡眠质量的影响. 中国当代医药, 2014, 21(14): 136-138.
12.	向邱, 徐素琴, 陈华文, 等. 重症监护室患者睡眠剥夺的集束护理干预策略. 护理学杂志, 2013, 28(11): 32-33.
13.	连小勤, 肖斌, 关风光, 等. 中药药枕对重症监护室病人睡眠质量的影响. 全科护理, 2015, 13(19): 1833-1835.
14.	郑静霞, 张利娟, 蔡静, 等. 耳穴压豆对 ICU 机械通气睡眠障碍患者睡眠质量的影响. 世界中西医结合杂志, 2017, 12(8): 1129-1135.
15.	Daneshmandi M, Neiseh F, SadeghiShermeh M, et al. Effect of eye mask on sleep quality in patients with acute coronary syndrome. J Caring Sci, 2012, 1(3): 135-143.
16.	Babaii A, Adib-Hajbaghery M, Hajibagheri A. Effect of using eye mask on sleep quality in cardiac patients: a randomized controlled trial. Nurs Midwifery Stud, 2015, 4(4): e28332.
17.	Hu RF, Jiang XY, Hegadoren KM, et al. Effects of earplugs and eye masks combined with relaxing music on sleep, melatonin and cortisol levels in ICU patients: a randomized controlled trial. Crit Care, 2015, 19: 115.
18.	盛孝敏, 甘秀妮, 张传来, 等. 夜间使用眼罩耳塞对 ICU 患者谵妄及睡眠障碍的疗效观察. 中国医科大学学报, 2013, 42(5): 463-465.
19.	Rittayamai N, Wilcox E, Drouot X, et al. Positive and negative effects of mechanical ventilation on sleep in the ICU: a review with clinical recommendations. Intensive Care Med, 2016, 42(4): 531-541.
20.	Pulak LM, Jensen L. Sleep in the intensive care unit: a review. J Intensive Care Med, 2016, 31(1): 14-23.
21.	Andersen JH, Boesen HC, Skovgaard Olsen K. Sleep in the intensive care unit measured by polysomnography. Minerva Anestesiol, 2013, 79(7): 804-815.
22.	刘茜, 姜亚芳. 重症监护病房患者睡眠质量的研究现状. 护理学杂志, 2012, 27(1): 90-92.
23.	Hu RF, Jiang XY, Chen J, et al. Non-pharmacological interventions for sleep promotion in the intensive care unit. Cochrane Database Syst Rev, 2015, (10): CD008808.
24.	Demoule A, Carreira S, Lavault S, et al. Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study. Crit Care, 2017, 21(1): 284.
25.	何海霞. 心脏患者 ICU 中睡眠剥夺护理干预措施及效果评价. 海南医学, 2012, 25(7): 316-319.
26.	勾涛燕, 罗秀琴, 刘晓琴, 等. 中医情志护理在 ICU 患者中的应用研究. 四川中医, 2015, 33(10): 175-176.
27.	杨丽. 浅析对冠心病患者实施中医情志护理的效果观察. 中医临床研究, 2013, 5(5): 112-113.
28.	韩琳, 李继平, 钟月欢, 等. 机械通气患者实施音乐干预的随机对照研究. 中华现代护理杂志, 2010, 16(14): 1613-1616.
29.	Chen JH, Chao YH, Lu SF, et al. The effectiveness of valerian acupressure on the sleep of ICU patients: a randomized clinical trial. Int J Nurs Stud, 2012, 49(8): 913-920.
30.	Ryu MJ, Park JS, Park H. Effect of sleep-inducing music on sleep in persons with percutaneous transluminal coronary angiography in the cardiac care unit. J Clin Nurs, 2012, 21(5-6): 728-735.
31.	王秦豫, 马玲, 刘扬, 等. 中药药枕结合穴位按摩施护改善焦虑病人睡眠障碍的护理观察. 新疆中医药, 2013, 31(5): 93-94.
32.	郑瑞双, 李乐之. ICU 病人的睡眠状况研究现状. 中华现代护理杂志, 2010, 16(5): 611-613.
33.	魏思宁, 王鸿庆, 郭栋. 耳穴压豆疗法对不同证型原发性高血压即时降压疗效比较. 山东中医杂志, 2016, 35(4): 328-329.

1. 周瑜利, 谢国红. ICU 病人睡眠障碍的相关因素调查. 当代护士(学术版), 2011, (7): 134-136.
2. Auger RR. Clinical sleep disorders. Philadelphia: LWW, 2012: 1010-1011.
3. Hauri PJ. Can we mix behavioral therapy with hypnotics when treating insomniacs? Sleep, 1997, 20(12): 1111-1118.
4. 刘爱萍, 李伦, 赵晔, 等. 当归多糖抗辐射效果的网状 Meta 分析. 中国药物评价, 2014, 31(2): 107-112.
5. Cope S, Jansen JP. Quantitative summaries of treatment effect estimates obtained with network meta-analysis of survival curves to inform decision-making. BMC Med Res Methodol, 2013, 13: 147.
6. Salanti G, Dias S, Welton NJ, et al. Evaluating novel agent effects in multiple-treatments meta-regression. Stat Med, 2010, 29(23): 2369-2383.
7. Hansen IP, Langhorn L, Dreyer P. Effects of music during daytime rest in the intensive care unit. Nurs Crit Care, 2018, 23(4): 207-213.
8. 张清, 姚小红, 汪海芹. 护理干预对 ICU 清醒患者不良情绪和睡眠质量的影响探析. 中国实用医药, 2017, 12(8): 169-171.
9. 王琳. 个性化音乐疗法结合中医情志护理对 ICU 患者心理和睡眠情况的影响. 齐鲁护理杂志, 2018, 24(15): 111-113.
10. 陈鸿. 护理干预对 ICU 患者术后睡眠质量的影响. 中国初级卫生保健, 2009, 23(10): 123-124.
11. 佘克蓉. 护理干预对 ICU 患者睡眠质量的影响. 中国当代医药, 2014, 21(14): 136-138.
12. 向邱, 徐素琴, 陈华文, 等. 重症监护室患者睡眠剥夺的集束护理干预策略. 护理学杂志, 2013, 28(11): 32-33.
13. 连小勤, 肖斌, 关风光, 等. 中药药枕对重症监护室病人睡眠质量的影响. 全科护理, 2015, 13(19): 1833-1835.
14. 郑静霞, 张利娟, 蔡静, 等. 耳穴压豆对 ICU 机械通气睡眠障碍患者睡眠质量的影响. 世界中西医结合杂志, 2017, 12(8): 1129-1135.
15. Daneshmandi M, Neiseh F, SadeghiShermeh M, et al. Effect of eye mask on sleep quality in patients with acute coronary syndrome. J Caring Sci, 2012, 1(3): 135-143.
16. Babaii A, Adib-Hajbaghery M, Hajibagheri A. Effect of using eye mask on sleep quality in cardiac patients: a randomized controlled trial. Nurs Midwifery Stud, 2015, 4(4): e28332.
17. Hu RF, Jiang XY, Hegadoren KM, et al. Effects of earplugs and eye masks combined with relaxing music on sleep, melatonin and cortisol levels in ICU patients: a randomized controlled trial. Crit Care, 2015, 19: 115.
18. 盛孝敏, 甘秀妮, 张传来, 等. 夜间使用眼罩耳塞对 ICU 患者谵妄及睡眠障碍的疗效观察. 中国医科大学学报, 2013, 42(5): 463-465.
19. Rittayamai N, Wilcox E, Drouot X, et al. Positive and negative effects of mechanical ventilation on sleep in the ICU: a review with clinical recommendations. Intensive Care Med, 2016, 42(4): 531-541.
20. Pulak LM, Jensen L. Sleep in the intensive care unit: a review. J Intensive Care Med, 2016, 31(1): 14-23.
21. Andersen JH, Boesen HC, Skovgaard Olsen K. Sleep in the intensive care unit measured by polysomnography. Minerva Anestesiol, 2013, 79(7): 804-815.
22. 刘茜, 姜亚芳. 重症监护病房患者睡眠质量的研究现状. 护理学杂志, 2012, 27(1): 90-92.
23. Hu RF, Jiang XY, Chen J, et al. Non-pharmacological interventions for sleep promotion in the intensive care unit. Cochrane Database Syst Rev, 2015, (10): CD008808.
24. Demoule A, Carreira S, Lavault S, et al. Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study. Crit Care, 2017, 21(1): 284.
25. 何海霞. 心脏患者 ICU 中睡眠剥夺护理干预措施及效果评价. 海南医学, 2012, 25(7): 316-319.
26. 勾涛燕, 罗秀琴, 刘晓琴, 等. 中医情志护理在 ICU 患者中的应用研究. 四川中医, 2015, 33(10): 175-176.
27. 杨丽. 浅析对冠心病患者实施中医情志护理的效果观察. 中医临床研究, 2013, 5(5): 112-113.
28. 韩琳, 李继平, 钟月欢, 等. 机械通气患者实施音乐干预的随机对照研究. 中华现代护理杂志, 2010, 16(14): 1613-1616.
29. Chen JH, Chao YH, Lu SF, et al. The effectiveness of valerian acupressure on the sleep of ICU patients: a randomized clinical trial. Int J Nurs Stud, 2012, 49(8): 913-920.
30. Ryu MJ, Park JS, Park H. Effect of sleep-inducing music on sleep in persons with percutaneous transluminal coronary angiography in the cardiac care unit. J Clin Nurs, 2012, 21(5-6): 728-735.
31. 王秦豫, 马玲, 刘扬, 等. 中药药枕结合穴位按摩施护改善焦虑病人睡眠障碍的护理观察. 新疆中医药, 2013, 31(5): 93-94.
32. 郑瑞双, 李乐之. ICU 病人的睡眠状况研究现状. 中华现代护理杂志, 2010, 16(5): 611-613.
33. 魏思宁, 王鸿庆, 郭栋. 耳穴压豆疗法对不同证型原发性高血压即时降压疗效比较. 山东中医杂志, 2016, 35(4): 328-329.

Chinese Journal of Evidence-Based Medicine

Efficacy of non-pharmacological interventions to improve sleep quality in ICU patients: a network meta-analysis

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