Non‐pharmacological interventions for sleep promotion in the intensive care unit

Background Adults in intensive care units (ICUs) often suffer from a lack of sleep or frequent sleep disruptions. Non‐pharmacological interventions can improve the duration and quality of sleep and decrease the risk of sleep disturbance, delirium, post‐traumatic stress disorder (PTSD), and the length of stay in the ICU. However, there is no clear evidence of the effectiveness and harms of different non‐pharmacological interventions for sleep promotion in adults admitted to the ICU. Objectives To assess the efficacy of non‐pharmacological interventions for sleep promotion in critically ill adults in the ICU. To establish whether non‐pharmacological interventions are safe and clinically effective in improving sleep quality and reducing length of ICU stay in critically ill adults. To establish whether non‐pharmacological interventions are cost effective. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2014, Issue 6), MEDLINE (OVID, 1950 to June 2014), EMBASE (1966 to June 2014), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to June 2014), Institute for Scientific Information (ISI) Web of Science (1956 to June 2014), CAM on PubMed (1966 to June 2014), Alt HealthWatch (1997 to June 2014), PsycINFO (1967 to June 2014), the China Biological Medicine Database (CBM‐disc, 1979 to June 2014), and China National Knowledge Infrastructure (CNKI Database, 1999 to June 2014). We also searched the following repositories and registries to June 2014: ProQuest Dissertations & Theses Global, the US National Institutes of Health Ongoing Trials Register (www.clinicaltrials.gov), the metaRegister of Controlled Trials (ISRCTN Register) (www.controlled‐trials.com), the Chinese Clinical Trial Registry (www.chictr.org.cn), the Clinical Trials Registry‐India (www.ctri.nic.in), the Grey Literature Report from the New York Academy of Medicine Library (www.greylit.org), OpenGrey (www.opengrey.eu), and the World Health Organization International Clinical Trials Registry platform (www.who.int/trialsearch). We handsearched critical care journals and reference lists and contacted relevant experts to identify relevant unpublished data. Selection criteria We included all randomized controlled trials (RCT) and quasi‐RCTs that evaluated the effects of non‐pharmacological interventions for sleep promotion in critically ill adults (aged 18 years and older) during admission to critical care units or ICUs. Data collection and analysis