The Impact of Non-Pharmacological Sleep Interventions on Delirium Prevention and Sleep Improvement in Postoperative ICU Patients: A Systematic Review and Network Meta-Analysis.

Abstract

Objectives: Analyze the effectiveness of different non-pharmacological sleep interventions in preventing delirium among postoperative ICU patients.

Research methodology: We conducted a comprehensive search on PubMed, Cochrane Library, Web of Science, Embase, CINAHL, OpenGrey and reference lists up to May 2024.

Setting: We systematically searched all randomized controlled trials related to non-pharmacological sleep interventions for the prevention of delirium.

Results: The results of the network meta-analysis showed that, compared to Usual Care, multicomponent interventions are the most effective measures for preventing delirium in postoperative ICU patients (RR = 0.32, 95 % CI = 0.20 to 0.51). This is followed by non-pharmacological sleep interventions aimed at stress relief (RR = 0.60, 95 % CI = 0.41 to 0.89) and circadian rhythm (RR = 0.61, 95 % CI = 0.39 to 0.96). Additionally, non-pharmacological sleep interventions focusing on circadian rhythm demonstrated an improvement in sleep quality among postoperative ICU patients (SMD = -0.99, 95 % CI = -1.88 to -0.11).

Conclusions: Our study found that multicomponent non-pharmacological sleep interventions are effective in reducing the incidence of delirium in postoperative ICU patients. Furthermore, non-pharmacological interventions focused on circadian rhythm regulation significantly enhance sleep quality among these patients.

Implications for clinical practice: Based on this study, intensive care units and nursing staff have an opportunity to implement the most effective non-pharmacological sleep interventions to prevent delirium and improve sleep quality in postoperative ICU patients. This could contribute to a reduction in the incidence of delirium in postoperative ICU patients.