Does improving sleep for the critically ill reduce the incidence and duration of delirium? An evidence‐based review

Abstract

Delirium is associated with poor patient outcome. Critical‐care nurses maintain that patients with disrupted sleep appear to develop delirium. We sought to explore whether improving sleep in the critically ill patients reduced the incidence and duration of delirium. Our review of five relevant studies suggests that there is low‐quality evidence that improving sleep may reduce the incidence of delirium. The bidirectional association between delirium and sleep stymies research in this area, and thus, establishing cause and effect, is difficult. Research exploring other patient‐centred outcomes, such as pain intensity, suggests that enhancing sleep may improve these outcomes.

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“…Lee and Roh 4 investigated the knowledge, barriers and training of nurses caring for patients with delirium in the Republic of Korea; Xu et al 5 and Wu et al 6 examined the risk factors of delirium in paediatric and adult intensive care unit (ICU) patients respectively; whereas Mortensen et al 7 and Castillejos et al 8 explored the experiences and the psychological symptoms of ICU survivors who had experienced delirium or difficult sedation 1 year after being discharged. Other papers report on clinical trials, observational studies or reviews investigating the potential impact of preoperative cardiac care unit visits, 9 eye masks and ear plugs, 10 sensory stimulation, 11 early sedation with dexmedetomidine, 12 non-pharmacological interventions 13 and improved sleep quality 14 on the prevention of delirium in critically ill patients.…”