Earplugs improve patients' subjective experience of sleep in critical care

Aims: This study aimed to determine the effects of earplug use on the subjective experience of sleep for patients in critical care. Background: The negative effects of noise in critical care include sleep disturbances, increased stress response, and reduced patient satisfaction. The nature of critical care often precludes quiet time protocols. Previous studies indicated that earplugs can improve REM sleep and sleep efficiency. This study examined the effects of earplugs as a non-invasive method for improving the subjective sleep experience and increasing patient satisfaction. Design: Quasi-experimental intervention study with random assignment of subjects. Method: Subjects were non-ventilated, non-sedated adults admitted to critical care. The intervention group used earplugs during nighttime sleep hours allowing short term removal during patient care. Participants completed the Verran-Snyder-Halpern Sleep Scale, an 8-question visual analogue scale, to describe their subjective response to sleep. Two sample T-tests were used to detect differences between the group scores. Results: 88 participants (49 intervention/39 control) completed the study. Mean age 63, 56% males, 93% Caucasian. Total sleep satisfaction scores were significantly better for the intervention group (p = .002). Seven of the subjective categories were independently significant (p = .005-.044). One category, satisfaction with the amount of time needed to fall asleep, was not significant (p = .111). Conclusions: Earplug use improved the subjective experience of sleep for un-medicated critical care patients without interfering with care delivery. Relevance to Practice: The negligible cost and low level of invasiveness of earplugs makes this preferable as a primary intervention to promote sleep while avoiding unnecessary sedating medications.