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

Video：

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Abstract Full text Figures/Tables Video References Cited by

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, 謝國紅. ICU 病人睡眠障礙的相關因素調查. 當代護士(學術版), 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.	劉愛萍, 李倫, 趙曄, 等. 當歸多糖抗輻射效果的網狀 Meta 分析. 中國藥物評價, 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.	張清, 姚小紅, 汪海芹. 護理干預對 ICU 清醒患者不良情緒和睡眠質量的影響探析. 中國實用醫藥, 2017, 12(8): 169-171.
9.	王琳. 個性化音樂療法結合中醫情志護理對 ICU 患者心理和睡眠情況的影響. 齊魯護理雜志, 2018, 24(15): 111-113.
10.	陳鴻. 護理干預對 ICU 患者術后睡眠質量的影響. 中國初級衛生保健, 2009, 23(10): 123-124.
11.	佘克蓉. 護理干預對 ICU 患者睡眠質量的影響. 中國當代醫藥, 2014, 21(14): 136-138.
12.	向邱, 徐素琴, 陳華文, 等. 重癥監護室患者睡眠剝奪的集束護理干預策略. 護理學雜志, 2013, 28(11): 32-33.
13.	連小勤, 肖斌, 關風光, 等. 中藥藥枕對重癥監護室病人睡眠質量的影響. 全科護理, 2015, 13(19): 1833-1835.
14.	鄭靜霞, 張利娟, 蔡靜, 等. 耳穴壓豆對 ICU 機械通氣睡眠障礙患者睡眠質量的影響. 世界中西醫結合雜志, 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, 張傳來, 等. 夜間使用眼罩耳塞對 ICU 患者譫妄及睡眠障礙的療效觀察. 中國醫科大學學報, 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.	劉茜, 姜亞芳. 重癥監護病房患者睡眠質量的研究現狀. 護理學雜志, 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. 心臟患者 ICU 中睡眠剝奪護理干預措施及效果評價. 海南醫學, 2012, 25(7): 316-319.
26.	勾濤燕, 羅秀琴, 劉曉琴, 等. 中醫情志護理在 ICU 患者中的應用研究. 四川中醫, 2015, 33(10): 175-176.
27.	楊麗. 淺析對冠心病患者實施中醫情志護理的效果觀察. 中醫臨床研究, 2013, 5(5): 112-113.
28.	韓琳, 李繼平, 鐘月歡, 等. 機械通氣患者實施音樂干預的隨機對照研究. 中華現代護理雜志, 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, 馬玲, 劉揚, 等. 中藥藥枕結合穴位按摩施護改善焦慮病人睡眠障礙的護理觀察. 新疆中醫藥, 2013, 31(5): 93-94.
32.	鄭瑞雙, 李樂之. ICU 病人的睡眠狀況研究現狀. 中華現代護理雜志, 2010, 16(5): 611-613.
33.	魏思寧, 王鴻慶, 郭棟. 耳穴壓豆療法對不同證型原發性高血壓即時降壓療效比較. 山東中醫雜志, 2016, 35(4): 328-329.

1. 周瑜利, 謝國紅. ICU 病人睡眠障礙的相關因素調查. 當代護士(學術版), 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. 劉愛萍, 李倫, 趙曄, 等. 當歸多糖抗輻射效果的網狀 Meta 分析. 中國藥物評價, 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. 張清, 姚小紅, 汪海芹. 護理干預對 ICU 清醒患者不良情緒和睡眠質量的影響探析. 中國實用醫藥, 2017, 12(8): 169-171.
9. 王琳. 個性化音樂療法結合中醫情志護理對 ICU 患者心理和睡眠情況的影響. 齊魯護理雜志, 2018, 24(15): 111-113.
10. 陳鴻. 護理干預對 ICU 患者術后睡眠質量的影響. 中國初級衛生保健, 2009, 23(10): 123-124.
11. 佘克蓉. 護理干預對 ICU 患者睡眠質量的影響. 中國當代醫藥, 2014, 21(14): 136-138.
12. 向邱, 徐素琴, 陳華文, 等. 重癥監護室患者睡眠剝奪的集束護理干預策略. 護理學雜志, 2013, 28(11): 32-33.
13. 連小勤, 肖斌, 關風光, 等. 中藥藥枕對重癥監護室病人睡眠質量的影響. 全科護理, 2015, 13(19): 1833-1835.
14. 鄭靜霞, 張利娟, 蔡靜, 等. 耳穴壓豆對 ICU 機械通氣睡眠障礙患者睡眠質量的影響. 世界中西醫結合雜志, 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, 張傳來, 等. 夜間使用眼罩耳塞對 ICU 患者譫妄及睡眠障礙的療效觀察. 中國醫科大學學報, 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. 劉茜, 姜亞芳. 重癥監護病房患者睡眠質量的研究現狀. 護理學雜志, 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. 心臟患者 ICU 中睡眠剝奪護理干預措施及效果評價. 海南醫學, 2012, 25(7): 316-319.
26. 勾濤燕, 羅秀琴, 劉曉琴, 等. 中醫情志護理在 ICU 患者中的應用研究. 四川中醫, 2015, 33(10): 175-176.
27. 楊麗. 淺析對冠心病患者實施中醫情志護理的效果觀察. 中醫臨床研究, 2013, 5(5): 112-113.
28. 韓琳, 李繼平, 鐘月歡, 等. 機械通氣患者實施音樂干預的隨機對照研究. 中華現代護理雜志, 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, 馬玲, 劉揚, 等. 中藥藥枕結合穴位按摩施護改善焦慮病人睡眠障礙的護理觀察. 新疆中醫藥, 2013, 31(5): 93-94.
32. 鄭瑞雙, 李樂之. ICU 病人的睡眠狀況研究現狀. 中華現代護理雜志, 2010, 16(5): 611-613.
33. 魏思寧, 王鴻慶, 郭棟. 耳穴壓豆療法對不同證型原發性高血壓即時降壓療效比較. 山東中醫雜志, 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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