PT - JOURNAL ARTICLE AU - Melissa P Knauert AU - Margaret Pisani AU - Nancy Redeker AU - Terry Murphy AU - Katy Araujo AU - Sangchoon Jeon AU - Henry Yaggi TI - Pilot study: an intensive care unit sleep promotion protocol AID - 10.1136/bmjresp-2019-000411 DP - 2019 Jun 01 TA - BMJ Open Respiratory Research PG - e000411 VI - 6 IP - 1 4099 - http://bmjopenrespres.bmj.com/content/6/1/e000411.short 4100 - http://bmjopenrespres.bmj.com/content/6/1/e000411.full SO - BMJ Open Resp Res2019 Jun 01; 6 AB - Purpose Disturbances, such as in-room activity and sound, are significant sources of sleep disruption among critically ill patients. These factors are potentially modifiable. We tested the impact of an intensive care unit (ICU) sleep promotion protocol on overnight in-room disturbance.Methods Our protocol restricted non-urgent bedside care from 00:00 to 03:59. Patients were assigned to usual care (n=30) or the sleep protocol (n=26). The primary outcomes were measures of in-room activity, sound and light. These three types of disturbance were compared between arms during a baseline time block (20:00–23:59) and a rest time block (00:00–03:59). We assessed the sleep protocol effect with generalised linear models.Results Usual care and sleep protocol patients had equivalent levels of in-room activity, sound and light during the baseline time block (20:00–23:59). In contrast, during the rest time block (00:00–03:59), the sleep protocol arm had 32% fewer room entries (rate ratio (RR) 0.68, p=0.001) and 9.1 fewer minutes of in-room activity (p=0.0002). Also, the length of time between room entrances increased from 26.4 to 45.8 min (p=0.0004). The sleep protocol arm also had lower sound during the rest time block. Mean A-weighted sound was 2.5 decibels lower (p=0.02), and there were 36% fewer peaks (RR 0.64, p=0.02). Light levels were highly variable and not changed by the sleep protocol.Conclusions Sleep promotion protocols can improve in-room activity and sound. This provides a better sleep opportunity and may, therefore, improve ICU sleep.Trial registration number 1112009428