Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment

Abstract

IntroductionEnvironmental stimulus, especially noise and light, is thought to disrupt sleep in patients in the intensive care unit (ICU). This study aimed to determine the physiological and psychological effects of ICU noise and light, and of earplugs and eye masks, used in these conditions in healthy subjects.MethodsFourteen subjects underwent polysomnography under four conditions: adaptation, baseline, exposure to recorded ICU noise and light (NL), and NL plus use of earplugs and eye masks (NLEE). Urine was analyzed for melatonin and cortisol levels. Subjects rated their perceived sleep quality, anxiety levels and perception of environmental stimuli.ResultsSubjects had poorer perceived sleep quality, more light sleep, longer rapid eye movement (REM) latency, less REM sleep when exposed to simulated ICU noise and light (P < 0.05). Nocturnal melatonin (P = 0.007) and cortisol secretion levels (P = 0.004) differed significantly by condition but anxiety levels did not (P = 0.06). Use of earplugs and eye masks resulted in more REM time, shorter REM latency, less arousal (P < 0.05) and elevated melatonin levels (P = 0.002).ConclusionsEarplugs and eye masks promote sleep and hormone balance in healthy subjects exposed to simulated ICU noise and light, making their promotion in ICU patients reasonable.

Do Earplugs and Eye Masks Affect Sleep and Delirium Outcomes in the Critically Ill?

“…Half of the studies assessed the effect of using the earplug or eyemask intervention for only 1 night, [11][12][13] whereas the others evaluated use for up to 5 nights. 5,[8][9][10] Sleep was predominantly measured through self-report of sleep quality/quantity, as well as factors that prevented and promoted reported psychometrics. One study measured sleep variables objectively by using polysomnography in a simulated critical care environment.…”

“…5,[9][10][11]13 One investigation used the Verran-SynderHalpern Sleep Scale, 12 whereas others used the Richards-Campbell Sleep Questionnaire 10 or the Sleep Assessment Tool, 13 the latter of which has no …”

A clinical study of adjuvant chemotherapy in younger and elder rectal cancer patientsA

“…In this study, it was found that patients in both groups had a mild level of state anxiety before application and a moderate level of state anxiety after application. In a study by Hu et al (2010), the mean state anxiety level before the application of earplugs and eye masks was found to be 32.5 ± 5.6, and after the application of earplugs and eye masks it was found to be 29.8 ± 6.4. In a study by Jones and Dawson (2012), 60% of patients in the experimental group and only 2% of patients in the control group defined state anxiety as a factor which prevented them from sleeping [32].…”

“…They found that the mean score for sleep quality was 10.78 ± 4.78 as measured by PSQI [36]. A study by Hu et al (2010) examined the effect of earplugs and eye masks on sleep; and the mean PSQI score for nights when the earplugs and eye masks were not used was found to be 4.1 ± 1.7, and for nights when the earplugs and eye masks were used it was found to be 2.3 ± 1.3 [31,34]. In a study by Yalçın Atar et al (2012) with 107 patients from a surgery clinic, it was found that the sleep quality of 55.1% of patients was poor according to the PSQI.…”

“…Hu et al (2010) examined the efficacy of earplugs and eye masks on sleep quality and anxiety level in 14 healthy subjects exposed to simulated intensive care unit noise and light and found that earplugs and eye masks improved sleep [31]. Jones and Dawson (2012) examined the effect of using eye masks and earplugs on selfreported sleep experience and factors affecting sleep quality in 100 patients and concluded that the intervention group identified earplugs (22%) and eye masks (28%) as factors promoting sleep [32].…”