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Adult nursing
Noise and light are the primary drivers for disrupting sleep in adults in intensive care
  1. Felicia Cox
  1. Pain Management, RBHFT, Harfield, UK
  1. Correspondence to Felicia Cox, RBHFT, Harfield UB9 6JH, UK; F.cox{at}

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Commentary on: Honarmand K, Rafay H, Le J et al. A systematic review of Risk Factors for Sleep Disruption in Critically Ill Adults. Crit Care Med. 2020. E-Pub DOI: 10.1097/CCM.0000000000004405

Implications for practice and research

  • Staff need to promote sleep in critical care by recognising and acting on modifiable factors such as noise and lighting levels.

  • Adequately powered and stratified studies are needed to establish causality between potential risk factors and poor sleep.


Sleep disruption impacts physical and mental health outcomes. The intensive care unit (ICU) is a less than perfect environment to care for critically ill patients. There are high rates of arousal, unintentional waking to deliver patient care and a lack of a clear day/night cycle1 which leads to decreased slow-wave sleep and low levels of rapid eye movement sleep. Sedative medicines used to reduce anxiety, promote comfort and enable care can also contribute to …

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  • Twitter @FeliciaJCox

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.