The effect of earplugs during the night on the onset of delirium and sleep perception: a randomized controlled trial in intensive care patients

This study hypothesised that a reduction of sound during the night using earplugs could be beneficial in the prevention of intensive care delirium. Two research questions were formulated. First, does the use of earplugs during the night reduce the onset of delirium or confusion in the ICU? Second, d...

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Published in:	Critical care (London, England) Vol. 16; no. 3; p. R73
Main Authors:	Van Rompaey, Bart, Elseviers, Monique M, Van Drom, Wim, Fromont, Veronique, Jorens, Philippe G
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 04-05-2012 BioMed Central
Subjects:	Adolescent Adult Aged Aged, 80 and over Clinical trials Critical Care - methods Delirium Delirium - diagnosis Delirium - prevention & control Delirium - psychology Ear Protective Devices - utilization Female Humans Intensive Care Units Male Medical research Medicine, Experimental Middle Aged Perception - physiology Prevention Single-Blind Method Sleep Sleep - physiology Young Adult
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Summary:	This study hypothesised that a reduction of sound during the night using earplugs could be beneficial in the prevention of intensive care delirium. Two research questions were formulated. First, does the use of earplugs during the night reduce the onset of delirium or confusion in the ICU? Second, does the use of earplugs during the night improve the quality of sleep in the ICU? A randomized clinical trial included adult intensive care patients in an intervention group of 69 patients sleeping with earplugs during the night and a control group of 67 patients sleeping without earplugs during the night. The researchers were blinded during data collection. Assignment was performed by an independent nurse researcher using a computer program. Eligible patients had an expected length of stay in the ICU of more than 24 hours, were Dutch- or English-speaking and scored a minimum Glasgow Coma Scale of 10. Delirium was assessed using the validated NEECHAM scale, sleep perception was reported by the patient in response to five questions. The use of earplugs during the night lowered the incidence of confusion in the studied intensive care patients. A vast improvement was shown by a Hazard Ratio of 0.47 (95% confidence interval (CI) 0.27 to 0.82). Also, patients sleeping with earplugs developed confusion later than the patients sleeping without earplugs. After the first night in the ICU, patients sleeping with earplugs reported a better sleep perception. Earplugs may be a useful instrument in the prevention of confusion or delirium. The beneficial effects seem to be strongest within 48 hours after admission. The relation between sleep, sound and delirium, however, needs further research. Current Controlled Trials ISRCTN36198138.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	1364-8535 1466-609X 1364-8535
DOI:	10.1186/cc11330