Sleep impairment and sleep promotion in intensive care units: an integrative review

Abstract

Objective:

To identify, in the scientific databases, evidence of factors that impair sleep and nursing interventions to promote sleep in Intensive Care Units.

Methods:

An integrative literature review was conducted across the databases MEDLINE and CINAHL and the Cochrane Database of Systematic Reviews between May and June 2019 using the PICO framework, seeking to answer the guiding questions of the study. The languages included in the literature review were English, Portuguese, and Spanish.

Results:

One hundred and ten studies were identified, twelve of which were considered eligible for review. The analysis of the articles found that sleep impairment is multicausal, being influenced mainly by the patient’s environmental and physical discomfort. Nursing interventions, such as environmental management of noise and light, grouping of care procedures, and control of pain and anxiety in the hospitalized patient, are fundamental for sleep quality.

Conclusion:

The academic literature shows that the nursing interventions identified, particularly those that promote the patient’s environmental and physical comfort, contribute to the quality of sleep in Intensive Care Units. However, promotion of the patient’s psychospiritual and social comfort is still lacking, given the focus and priorities of this type of hospitalization.

Keywords
Sleep; Patient confort; Intensive care units; Nursing care; Sleep wake disorders