Effect of a Multicomponent Sleep Protocol on Sleep Quality in Conscious Patients in the Intensive Care Unit

Objective: Sleep disruption is common in patients admitted in the intensive care unit (ICU), and it is associated with various negative effects. This study aimed to investigate whether the implementation of a multicomponent sleep protocol improved the quality of sleep, both subjectively (assessed with a questionnaire) and objectively (measured using actigraphy). Materials and Methods: A prospective interventional non-randomized controlled study compared two groups (PRE and POST groups) of 20 spontaneously conscious ICU patients. Results: Subjectively evaluated sleep quality was poor in the entire sample (n=40) [Richards-Campbell Sleep Questionnaire (RCSQ) total 49.2 +/- 25.1]. The mean total sleep time was 389.0 +/- 78.8 min, the Sleep Efficiency index (SEI) was 81.1 +/- 16.4%, and the number of awakenings per night was 18.4 +/- 9.79. The quality of sleep (both subjective and objective) was not significantly improved following the application of the sleep protocol (POST group), as inferred from most of the studied parameters. Subjective assessment yielded better results (RCSQ total: 45.1 PRE vs 51.1 POST); however, they were not statistically significant. Paradoxically, statistically significantly better results were observed for SEI (86.6% PRE vs 75.9% POST, p=0.044), total sleep time (416 min PRE vs 364 min POST, p=0.044), and noise (T=2.11, p=0.046) in the control group. Conclusion: Although the results failed to confirm that the multicomponent protocol exerted a significant effect, its implementation in clinical practice may be valuable. In a selected group of ICU patients, the proposed interventions may aid in achieving good sleep and in improving their overall comfort.