How to improve inpatient sleep in regular care wards: a systematic review and meta-analysis of sleep disturbers and non-pharmacological interventions.
Study Goal
The researchers aimed to assess the effectiveness of non-pharmacological interventions, including massage, in improving sleep for inpatients in regular care wards.
Results Summary
The meta-analysis revealed large pooled effects in favor of sleep improvement with massage, though the certainty of evidence ranged from moderate to very low.
Population
Inpatients in regular care wards experiencing sleep disturbances.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
eye masks and earplugs | increase | sleep | inpatients admitted to regular care wards | large pooled effects | revealed large pooled effects in favor of sleep | #1 |
headphones and white noise | increase | sleep | inpatients admitted to regular care wards | large pooled effects | revealed large pooled effects in favor of sleep | #2 |
aromatherapy | increase | sleep | inpatients admitted to regular care wards | large pooled effects | revealed large pooled effects in favor of sleep | #3 |
massage | increase | sleep | inpatients admitted to regular care wards | large pooled effects | revealed large pooled effects in favor of sleep | #4 |
muscle relaxation and breathing exercises | increase | sleep | inpatients admitted to regular care wards | large pooled effects | revealed large pooled effects in favor of sleep | #5 |
advanced nursing strategies | increase | sleep | inpatients admitted to regular care wards | large pooled effects | revealed large pooled effects in favor of sleep | #6 |
OBJECTIVE: To determine factors affecting inpatient sleep and assess the range and effectiveness of non-pharmacological interventions aimed at improving the sleep of patients admitted to regular care wards. METHODS: A systematic literature search was conducted in five scientific databases, including articles published from inception to June 23rd, 2023. Eligible studies evaluated sleep disturbing factors or the effect of non-pharmacological intervention(s). Meta-analyses on intervention studies were conducted using a random effects model. Certainty of evidence was assessed using the GRADE approach. RESULTS: Out of 591 potentially eligible studies, 229 were included in this review. Sleep disturbers were identified in 153 studies, and 102 studies were eligible for meta-analysis. Common factors contributing to poor sleep included noise, light, care-related interruptions, pain, and anxiety. The meta-analyses revealed large pooled effects in favor of sleep for the use of eye masks and earplugs, headphones and white noise, aromatherapy, massage, muscle relaxation and breathing exercises, and advanced nursing strategies. However, the certainty of the evidence ranged from moderate to very low. CONCLUSION: Inpatient sleep is often disturbed by patient-related, care-related, and environmental factors. While there are promising non-pharmacological interventions, the overall quality of studies, heterogeneity in study populations, and differences in outcome measures present challenges for drawing definitive conclusions.