Non-Pharmacologic Interventions to Improve the Sleep of Hospitalized Patients: A Systematic Review

Abstract

There is insufficient to low strength of evidence that any non-pharmacologic intervention improves sleep quality or quantity of general inpatients. Further studies are needed in this area to guide clinicians.

Non-pharmacologic interventions to improve sleep of medicine inpatients: a controlled study

“…While this is well-studied in outpatient settings, the inpatient literature is predominately in critical care units, where evidence suggests non-pharmacologic protocols decrease delirium and improve subjective sleep quality [6]. Similar studies in non-critical care settings exist but have inconsistent results and include costly and time-consuming interventions, such as white-light lamps or nursing-led relaxation techniques [7]. One previous study introduced a protocol that aimed to reduce interruptions and had outcome measures of quality of sleep and use of as-needed sleep medications.…”

The Effect of Inhalation Aromatherapy with Lavender on Sleep Quality of the Elderly in Nursing Care Homes: A Randomized Clinical Trial

“…Recently, non-pharmacological interventions were proposed, which are better than available techniques in the treatment of sleep disorders among elderly people (8). A drug-free approach is preferred, considering the potential risks of tolerance and dependence over the large number of other drugs, which older people with insomnia often take (4).…”

“…Implementation of the aromatherapy is simple, safe, available at relatively low cost, and involves minimal complications (8). Aromatherapy is the therapeutic use of essence oils, which is absorbed by the body in different ways-such as massage, inhalation, compression, aroma baths, and showers (9).…”

Using Music to Promote Sleep for Hospitalized Adults

“…Sleep problems exacerbate the healing process during hospitalization and can endure beyond hospitalization. [1][2][3] Researchers in one study 4 documented that sleep difficulties may endure beyond hospitalization: 50% of respondents reported moderate to severe sleep problems 1 week after discharge. Other studies have offered evidence that sleep problems experienced during hospitalization increase the risk for development of chronic insomnia.…”

“…However, use of sedatives has been linked to such adverse effects as memory loss, disorientation, increased fall risk, and daytime fatigue. 3 In recent years, growing emphasis has been placed on exploring the effectiveness of nonpharmacological interventions to promote sleep, such as minimizing nighttime disruptions, decreasing noise and light, increasing meaningful daytime activity, and using relaxation techniques (eg, aromatherapy, massage, guided imagery, ear plugs, and eye masks). 3 Music is another previously studied technique for promoting sleep.…”