The Effect of Earplugs and Eye Masks Usage in the Intensive Care Unit on Sleep Quality: Systematic Review

Abstract

<b><i>Introduction:</i></b> Patients in the intensive care unit (ICU) have severe and complex disease characteristics and their sleep problems should not be ignored. Poor-quality sleep is associated with impaired immune function and associated susceptibility to disease and infection, decreased energy levels, delirium, delays in recovery. This study is conducted to examine the results of studies examining sleep quality using earplugs and eye masks in the ICU. <b><i>Methods:</i></b> PubMed, Science Direct, Google Scholar, and Medline databases were scanned using “Earplugs, Eye masks, Sleep quality, Intensive care units” as keywords. For the search strategy, a query in a patient-intervention-compare-result (PICO) format was used. P: Patients in intensive care; I: Earplugs and eye mask; C: Noise, Light, and Sleep Quality; O: Using earplugs and eye masks improves sleep quality. <b><i>Results:</i></b> We included the 17 most eligible studies meeting defined inclusion/exclusion criteria involving 1,372 participants. Randomized controlled trial was used mostly as study design. The interventions within the scope of the studies were earplugs, eye masks, relaxing music, and quiet time protocol. Richard Campbell Sleep Questionnaire and Verran and Snydern Halpern Sleep Scale were the most used scale. Most of the studies reviewed found that the use of non-pharmacological interventions showed a significant improvement in sleep quality. Earplugs and eye masks were found to have potential positive effects on sleep quality and delirium incidence in ICU patients. <b><i>Conclusion:</i></b> The use of earplugs and eye masks is a noninvasive, economical, and effective way to improve sleep quality in adult ICU patients.

Effect of using eye masks and earplugs in preventing delirium in intensive care patients: A single‐blinded, randomized, controlled trial

“…Systematic review study by Polat et al earplugs and eye masks were found to have potential positive effects on sleep quality and delirium incidence. Also using earplugs and eye masks is a noninvasive, economical, and effective way to improve sleep quality in ICU patients 35 . Secondary objectives of this study were to measure the parameters thought to have an effect on delirium. Sleep quality : One important problem for ICU patients is the disruption of the sleep–wake cycle and its negative effects on patients' cognitive status 12,36 .…”

“…Also using earplugs and eye masks is a noninvasive, economical, and effective way to improve sleep quality in ICU patients. 35 Secondary objectives of this study were to measure the parameters thought to have an effect on delirium.…”

The effects of eye masks and earplugs on sleep quality, anxiety, fear, and vital signs in patients in an intensive care unit: A randomised controlled study

“…Hu et al (2015) investigated the effect of using earplugs and eye masks on sleep quality and melatonin levels in ICU patients and concluded that the use of earplugs and eye masks improved sleep and increased melatonin levels. In systematic reviews evaluating the short-and long-term benefits of eye masks and earplugs, they were found to have a positive effect on sleep quality (Fang et al, 2021;Locihová et al, 2018;Polat et al, 2022).…”

“…Hu et al (2015) investigated the effect of using earplugs and eye masks on sleep quality and melatonin levels in ICU patients and concluded that the use of earplugs and eye masks improved sleep and increased melatonin levels. In systematic reviews evaluating the short‐ and long‐term benefits of eye masks and earplugs, they were found to have a positive effect on sleep quality (Fang et al, 2021; Locihová et al, 2018; Polat et al, 2022). In a different meta‐analysis, it was reported that eye masks and earplugs provided a significant increase in total sleep time, sleep efficiency, REM time, and a significant decrease in awakening (Karimi et al, 2021).…”

“…In addition, eye masks and earplugs can reduce sleep deprivation by changing the environmental perception of the patients (Hu et al, 2010). It has been stated that the use of earplugs and eye masks is a non‐invasive, economical, and effective way to improve sleep quality in adult ICU patients (Polat et al, 2022).…”