Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment.docVIP

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Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment.doc

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Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment

Huetal.CriticalCare2010,14:R66 /content/14/2/R66 RESEARCH OpenAccess Effectsofearplugsandeyemasksonnocturnal sleep,melatoninandcortisolinasimulated intensivecareunitenvironment Rong-fangHu1,Xiao-yingJiang1*,Yi-mingZeng2,Xiao-yangChen2,You-huaZhang3 Abstract Introduction:Environmentalstimulus,especiallynoiseandlight,isthoughttodisruptsleepinpatientsinthe intensivecareunit(ICU).ThisstudyaimedtodeterminethephysiologicalandpsychologicaleffectsofICUnoise andlight,andofearplugsandeyemasks,usedintheseconditionsinhealthysubjects. Methods:Fourteensubjectsunderwentpolysomnographyunderfourconditions:adaptation,baseline,exposureto recordedICUnoiseandlight(NL),andNLplususeofearplugsandeyemasks(NLEE).Urinewasanalyzedfor melatoninandcortisollevels.Subjectsratedtheirperceivedsleepquality,anxietylevelsandperceptionof environmentalstimuli. Results:Subjectshadpoorerperceivedsleepquality,morelightsleep,longerrapideyemovement(REM)latency, lessREMsleepwhenexposedtosimulatedICUnoiseandlight(P0.05).Nocturnalmelatonin(P=0.007)and cortisolsecretionlevels(P=0.004)differedsignificantlybyconditionbutanxietylevelsdidnot(P=0.06).Useof earplugsandeyemasksresultedinmoreREMtime,shorterREMlatency,lessarousal(P0.05)andelevated melatoninlevels(P=0.002). Conclusions:Earplugsandeyemaskspromotesleepandhormonebalanceinhealthysubjectsexposedto simulatedICUnoiseandlight,makingtheirpromotioninICUpatientsreasonable. Introduction sleepdisruptorinICUsettings.Reportednocturnalillu- Sleep disruption is common in ICU patients and has mination in ICUs varies widely, with mean maximum beencharacterizedbyseveralstudiesusingpolysomno- levelsof5to1400lux[5,11].Lightexposureisthepri- graphy(PSG)[1-3].Adverseconsequencesofsleepdis- mary external cue for circadian rhythm. In addition, ruption include impaired immune function, decreased nocturnalmelatoninsecretioncanbeacutelysuppressed inspiratorymuscleendurance,negativelyaffectedwean- by light, and 100 lux is sufficient to impact nocturnal ingfrommechanical