A preintervention-postintervention study investigating the effect of a rest and sleep guideline on the amount and quality of sleep in intensive care patients

Patients’ median total sleep time was 05:00 (IQR: 02:52 to- 07:14). The majority of sleep was stage 1 and 2 (medians: 19 and 73%) with scant slow wave and REM sleep. The median duration of sleep without waking was 00:03. Sound levels were high (mean Leqeq 53.95 dB(A) during the day and 50.20 dB(A) at night) and illuminance levels were appropriate at night (median <2 lux) but low during the day (median: 74.20 lux). There was a median 1.7 care events/h. Patients’ mean self-reported sleep quality was poor. Interrater reliability of sleep staging was highest for slow wave sleep and lowest for stage 1 sleep. The comparison between the groups' sleep quality and quantity (before and after the implementation of the rest and sleep guideline) revealed no clinically or statistically significant results. The introduction of the Guideline did not appear to result in an improvement in sleep however Guideline uptake was limited. This investigation has revealed the need for alternative methods of analysing ICU patients’ PSG data. The study protocol demonstrates the feasibility of conducting further extensive investigations into potential relationships between patients’ sleep disruption and outcomes. The method in which the Guideline was developed may be of interest to other clinicians wishing to develop guidelines when research evidence is limited.