ABSTRACT
Van Rompaey B, Elseviers MM, Van Drom W, Fromont V, Jorens PG
INTRODUCTION: This study hypothesised that a reduction of sound
during the night using earplugs could be beneficial in the prevention of
intensive care delirium. Two research questions were formulated. First, does
the use of earplugs during the night reduce the onset of delirium or confusion
in the ICU? Second, does the use of earplugs during the night improve the
quality of sleep in the ICU?
METHODS: A randomized clinical trial included adult intensive
care patients in an intervention group of 69 patients sleeping with earplugs
during the night and a control group of 67 patients sleeping without earplugs
during the night. The researchers were blinded during data collection.
Assignment was performed by an independent nurse researcher using a computer
program. Eligible patients had an expected length of stay in the ICU of more
than 24 hours, were Dutch- or English-speaking and scored a minimum Glasgow
Coma Scale of 10. Delirium was assessed using the validated NEECHAM scale,
sleep perception was reported by the patient in response to five questions.
RESULTS: The use of earplugs during the night lowered the
incidence of confusion in the studied intensive care patients. A vast
improvement was shown by a Hazard Ratio of 0.47 (95% confidence interval (CI)
0.27 to 0.82). Also, patients sleeping with earplugs developed confusion later
than the patients sleeping without earplugs. After the first night in the ICU,
patients sleeping with earplugs reported a better sleep perception.
CONCLUSIONS: Earplugs may be a useful instrument in the prevention
of confusion or delirium. The beneficial effects seem to be strongest within 48
hours after admission. The relation between sleep, sound and delirium, however,
needs further research. (Crit Care. 2012
May 4;16(3):R73)
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Earplugs for Sleeping are useful for pleasant sleep and i also use it while reading books
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