The Impact of Interventions to Improve Sleep on Delirium in the ICU: A Systematic Review and Research Framework*

  title={The Impact of Interventions to Improve Sleep on Delirium in the ICU: A Systematic Review and Research Framework*},
  author={Alexander H. Flannery and Douglas R. Oyler and Gerald L. Weinhouse},
  journal={Critical Care Medicine},
Objective :This study aimed to assess whether interventions targeted at improving sleep in the ICU were associated with reductions in ICU delirium. Secondary outcomes include duration of delirium and ICU length of stay. Data Sources:MEDLINE, CINAHL, Web of Science, Scopus, WorldCat, and International Pharmaceutical Abstracts were searched from inception to January 2016. Study Selection:Studies investigating any type of sleep intervention (nonpharmacologic or pharmacologic) and assessing the… 
Effects of nonpharmacological interventions on sleep improvement and delirium prevention in critically ill patients: A systematic review and meta-analysis.
  • Jiyeon Kang, Y. Cho, Soogyeong Kim
  • Medicine, Psychology
    Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
  • 2022
Evaluation of the Impact of Prior-to-Admission Sleep Aid Prescribing Practices on Sleep and Delirium in the Intensive Care Unit
The incidence of delirium and sleep-wake cycle disturbances was not affected by differences in prior-to-admission sleep aid prescribing patterns during ICU admission and ICU length of stay was similar between the groups.
Development and Implementation of a Multicomponent Protocol to Promote Sleep and Reduce Delirium in a Medical Intensive Care Unit
This report demonstrates that implementation of a multicomponent sleep protocol in everyday ICU care is feasible, but limitations exist when evaluating impact on measurable outcomes.
Sleep and Delirium in Older Adults
This review highlights current research on poor sleep and delirium, their inter-relationship, modes of measurement, and current approaches to management, and concludes that Bundled non-pharmacologic approaches represent a promising framework for prevention and management.
Psychometric evaluation of the family caregiver ICU delirium knowledge questionnaire
Good validity and reliability of the CIDKQ as a measure of ICU delirium knowledge in family caregivers of critically ill patients is indicated.
Impact of sleep alterations on weaning duration in mechanically ventilated patients: a prospective study
It is suggested for the first time that brain dysfunction may have an influence on the ability to breathe spontaneously in intensive care unit patients under mechanical ventilation with altered sleep.
The effect of evidence-based cluster nursing intervention on the incidences of delirium and the prognoses of ICU patients.
Evidence-based cluster nursing intervention can conspicuously reduce the incidences of delirium, shorten the durations of the mechanical ventilation and the ICU stays, and improve patient prognosis, so it is worthy of clinical application.
Delirium in Cardiac Intensive Care Unit
Non-pharmacological measures such as avoiding delirium-risk medications, early physical rehabilitation, occupational therapy, and sleep improvement strategies have shown significant benefits in decreasing delirio, but pharmaceutical options are limited for use in CICU.


Delirium Transitions in the Medical ICU: Exploring the Role of Sleep Quality and Other Factors*
Infusion of benzodiazepine and/or opioid medications was strongly associated with transition to delirium in the ICU in mechanically ventilated patients and is an important, modifiable risk factor for deliria in critically ill patients.
The Effect of a Quality Improvement Intervention on Perceived Sleep Quality and Cognition in a Medical ICU*
An ICU-wide quality improvement intervention to improve sleep anddelirium is feasible and associated with significant improvements in perceived nighttime noise, incidence of delirium/coma, and daily delirio-coma-free status.
A Pilot Study to Test the Feasibility of a Nonpharmacologic Intervention for the Prevention of Delirium in the Medical Intensive Care Unit
A multicomponent prevention protocol consisting of sedation cessation, sleep-wake cycles, sensory stimulation, mobility, and music tested for prevention of delirium found little difference before and after intervention.
Intensive Care Delirium Screening Checklist: evaluation of a new screening tool
The Intensive Care Delirium Screening Checklist can easily be applied by a clinician or a nurse in a busy critical care setting to screen all patients even when communication is compromised, and helps to identify delirious patients.
Randomized ICU Trials Do Not Demonstrate an Association Between Interventions That Reduce Delirium Duration and Short-Term Mortality: A Systematic Review and Meta-Analysis*
A review of current evidence fails to support that ICU interventions that reduce delirium duration reduce short-term mortality, and meta-regression revealed that delIRium duration was not associated with reduced short- term mortality.
Effects of routine monitoring of delirium in a surgical/trauma intensive care unit
Daily screening for delirium did not affect the timing of pharmacologic therapy and although the intervention resulted in a higher number of delirious ICU patients being treated, particularly trauma patients, there was no effect on related outcomes.
Bench-to-bedside review: Delirium in ICU patients - importance of sleep deprivation
Sleep deprivation may prove to be a modifiable risk factor for the development of delirium with important implications for the acute and long-term outcome of critically ill patients.
Non-pharmacological interventions for sleep promotion in the intensive care unit.
All randomized controlled trials (RCT) and quasi-RCTs that evaluated the effects of non-pharmacological interventions for sleep promotion in critically ill adults during admission to critical care units or ICUs were evaluated.
Developing, Implementing, and Evaluating a Multifaceted Quality Improvement Intervention to Promote Sleep in an ICU
  • B. Kamdar, Jessica Yang, D. Needham
  • Medicine
    American journal of medical quality : the official journal of the American College of Medical Quality
  • 2014
The present article describes the specific QI framework used to develop and implement this intervention, which consists of summarizing the evidence to create a list of sleep-promoting interventions and selecting performance measures to assess intervention adherence and patient outcomes.