Earplugs and eye masks vs routine care prevent sleep impairment in post-anaesthesia care unit: a randomized study

Post-anaesthesia care units (PACUs) with 24/7 activity and consequently artificial light and noise may disturb the sleep of patients who require prolonged medical supervision. After one postoperative night, we compared sleep quality in patients with and without noise (earplug) and light (eye mask) protection.

After ethical board approval, 46 patients without any neurological or respiratory failure undergoing major non-cardiac surgery were prospectively included. They were randomized to sleep with or without protective devices during the first postoperative night in the PACU. Sleep quality was simultaneously measured by sleep-quality scales (Spiegel score and Medical Outcomes Study Sleep), nurses' assessment, and through a wrist actigraph (Actiwatch). Secondary outcomes such as pain control and nocturnal activity were recorded. Comparisons between groups were made by Student's t-test or non-parametric test for repeated measures as appropriate (SPSS 10.0). A P-value <0.05 was considered significant.

Data from 41 patients were analysed. Protective devices during the first postoperative night prevented a decrease in sleep quality compared with standard care, as evaluated by the Spiegel scale: 20 (4) vs 15 (5), P=0.006. These devices significantly decreased the need for a nap [50% 95% confidence interval (CI) (20-80) vs 95% 95% CI (85-100), P<0.001], but had no effect on sleep length evaluated by Actiwatch. The total consumption of morphine was significantly reduced in the first 24 h [respectively, 15(12) mg and 27(17) mg, P=0.02].

Earplugs and eye masks applied in the PACU during the first postoperative night significantly preserve sleep quality. Such non-invasive and cheap devices may be generalized in the PACU or in intensive care units.