***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction Environmental stimulus , especially noise and light , is thought to disrupt sleep in patients in the intensive care unit ( ICU ) . This study aim ed to determine the physiological and psychological effects of ICU noise and light , and of earplugs and eye masks , used in these conditions in healthy subjects . Methods Fourteen subjects underwent polysomnography under four conditions : adaptation , baseline , exposure to recorded ICU noise and light ( NL ) , and NL plus use of earplugs and eye masks ( NLEE ) . Urine was analyzed for melatonin and cortisol levels . Subjects rated their perceived sleep quality , anxiety levels and perception of environmental stimuli . Results Subjects had poorer perceived sleep quality , more light sleep , longer rapid eye movement ( REM ) latency , less REM sleep when exposed to simulated ICU noise and light ( P < 0.05 ) . Nocturnal melatonin ( P = 0.007 ) and cortisol secretion levels ( P = 0.004 ) differed significantly by condition but anxiety levels did not ( P = 0.06 ) . Use of earplugs and eye masks result ed in more REM time , shorter REM latency , less arousal ( P < 0.05 ) and elevated melatonin levels ( P = 0.002 ) . Conclusions Earplugs and eye masks promote sleep and hormone balance in healthy subjects exposed to simulated ICU noise and light , making their promotion in ICU patients reasonable AIM AND OBJECTIVE The study compared the effect of earplug-delivered sleep-inducing music on sleep in persons with percutaneous transluminal coronary angiography in the cardiac care unit . BACKGROUND Diverse types of music have been cl aim ed to improve sleeping elsewhere , but relatively little is known in South Korea . Most studies investigating the effect of sleep-inducing music on sleep have involved persons with insomnia , even though many persons with cardiovascular disease in the intensive care unit suffer from sleeping problems . There is a need to investigate the effect of sleep-inducing music on sleep disorders in persons with percutaneous transluminal coronary angiography in the cardiac care unit . DESIGN An experimental research design was used . METHODS Data collection was conducted in the cardiac care unit of K University Hospital in D city , from 3 September-4 October 2010 . Fifty-eight subjects participated and were r and omly assigned to the experimental group ( earplug-delivered sleep-inducing music for 52 min beginning at 10:00 pm , while wearing an eyeshield , n = 29 ) and the control group ( no music , but earplugs and eyeshield worn , n = 29 ) . The quantity and quality of sleep were measured using question naires at 7 am the next morning for each group . RESULTS Participants in the experimental group reported that the sleeping quantity and quality were significantly higher than control group ( t = 3·181 , p = 0·002 , t = 5·269 , p < 0·001 , respectively ) . CONCLUSION Sleep-inducing music significantly improved sleep in patients with percutaneous transluminal coronary angiography at a cardiac care unit . Offering earplugs and playing sleep-inducing music may be a meaningful and easily enacted nursing intervention to improve sleep for intensive care unit patients . RELEVANCE TO CLINICAL PRACTICE Nurses working at cardiac care unit can use music to improve sleeping in clients with percutaneous transluminal coronary angiography BACKGROUND 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 . METHODS After ethical board approval , 46 patients without any neurological or respiratory failure undergoing major non-cardiac surgery were prospect ively included . They were r and omized 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 . RESULTS Data from 41 patients were analysed . Protective devices during the first postoperative night prevented a decrease in sleep quality compared with st and ard 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 ] . CONCLUSIONS 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 Introduction This study hypothesised that a reduction of sound during the night using earplugs could be beneficial in the prevention of intensive care delirium .  Two research questions were formulated . First , does the use of earplugs during the night reduce the onset of delirium or confusion in the ICU ? Second , does the use of earplugs during the night improve the quality of sleep in the ICU ? Methods A r and omized clinical trial included adult intensive care patients in an intervention group of 69 patients sleeping with earplugs during the night and a control group of 67 patients sleeping without earplugs during the night . The research ers were blinded during data collection . Assignment was performed by an independent nurse research er using a computer program . Eligible patients had an expected length of stay in the ICU of more than 24 hours , were Dutch- or English-speaking and scored a minimum Glasgow Coma Scale of 10 .  Delirium was assessed using the vali date d NEECHAM scale , sleep perception was reported by the patient in response to five questions . Results The use of earplugs during the night lowered the incidence of confusion in the studied intensive care patients . A vast improvement was shown by a Hazard Ratio of 0.47 ( 95 % confidence interval ( CI ) 0.27 to 0.82 ) . Also , patients sleeping with earplugs developed confusion later than the patients sleeping without earplugs . After the first night in the ICU , patients sleeping with earplugs reported a better sleep perception . Conclusions Earplugs may be a useful instrument in the prevention of confusion or delirium . The beneficial effects seem to be strongest within 48 hours after admission . The relation between sleep , sound and delirium , however , needs further research .Trial registration Current Controlled Trials IS RCT Background : Patients in coronary care unit are at risk of sleep deprivation . Sleep deprivation can be associated with increased blood pressure and heart rate , raising the risk of developing cardiovascular problems among patients hospitalized in coronary care unit . Objectives : This study was carried out to examine the effect of eye mask on sleep quality in cardiac patients . Patients and Methods : In this r and omized controlled trial , 60 patients who met the inclusion criteria were selected using a convenient sampling method and r and omly allocated into the experimental and control groups . Patients in the control group received routine care . However , in the experimental group , patients received routine care and eye mask for three subsequent nights . In the both groups , the sleep quality was assessed using the Pittsburgh sleep quality index . Data were analyzed by the chi-square test , independent sample s t-test , Mann-Whitney U , and Wilcoxon signed-rank tests . Results : After the study , the median scores of the subjective sleep quality , the sleep latency , the sleep duration , the habitual sleep efficiency , and the sleep disturbances domains , as well as the median score of overall Pittsburgh sleep quality index in the experimental group were significantly lower than those in the control group ( P < 0.05 ) . However , no significant differences were observed between the two groups in terms of the use of sleep medications and the daytime dysfunction domains ( P > 0.05 ) . Conclusions : Using eye mask can significantly improve the sleep quality  in cardiac patients . Therefore , nurses are recommended to use eye mask in combination with current treatments for improving patients ’ sleep quality Introduction Intensive care unit ( ICU ) environmental factors such as noise and light have been cited as important causes of sleep deprivation in critically ill patients . Previous studies indicated that using earplugs and eye masks can improve REM sleep in healthy subjects in simulated ICU environment , and improve sleep quality in ICU patients . This study aim ed to determine the effects of using earplugs and eye masks with relaxing background music on sleep , melatonin and cortisol levels in ICU patients . Methods Fifty patients who underwent a scheduled cardiac surgery and were expected to stay at least 2 nights in Cardiac Surgical ICU ( CSICU ) were included . They were r and omized to sleep with or without earplugs and eye masks combined with 30-minute relaxing music during the postoperative nights in CSICU . Urine was analyzed for nocturnal melatonin and cortisol levels . Subjective sleep quality was evaluated using the Chinese version of Richards-Campbell Sleep Question naire ( a visual analog scale , ranging 0–100 ) . Results Data from 45 patients ( 20 in intervention group , 25 in control group ) were analyzed . Significant differences were found between groups in depth of sleep , falling asleep , awakenings , falling asleep again after awakening and overall sleep quality ( P < 0.05 ) . Perceived sleep quality was better in the intervention group . No group differences were found in urinary melatonin levels and cortisol levels for the night before surgery , and the first and second nights post-surgery ( P > 0.05 ) . The urinary melatonin levels of the first and second postoperative nights were significantly lower than those of the night before surgery ( P = 0.01 ) . The opposite pattern was seen with urinary cortisol levels ( P = 0.00 ) . Conclusion This combination of non-pharmacological interventions is useful for promoting sleep in ICU adult patients ; however , any influence on nocturnal melatonin levels and cortisol level may have been masked by several factors such as the timing of surgery , medication use and individual differences . Larger scale studies would be needed to examine the potential influences of these factors on biological markers and intervention efficacy on sleep . Trial registration Chinese Clinical Trial Registry : ChiCTR-IOR-14005511 . Registered 21 November 2014 Introduction Sleep deprivation is common in critically ill patients in the intensive care unit ( ICU ) . Noise and light in the ICU and the reduction in plasma melatonin play the essential roles . The aim of this study was to determine the effect of simulated ICU noise and light on nocturnal sleep quality , and compare the effectiveness of melatonin and earplugs and eye masks on sleep quality in these conditions in healthy subjects . Methods This study was conducted in two parts . In part one , 40 healthy subjects slept under baseline night and simulated ICU noise and light ( NL ) by a cross-over design . In part two , 40 subjects were r and omly assigned to four groups : NL , NL plus placebo ( NLP ) , NL plus use of earplugs and eye masks ( NLEE ) and NL plus melatonin ( NLM ) . 1 mg of oral melatonin or placebo was administered at 21:00 on four consecutive days in NLM and NLP . Earplugs and eye masks were made available in NLEE . The objective sleep quality was measured by polysomnography . Serum was analyzed for melatonin levels . Subjects rated their perceived sleep quality and anxiety levels . Results Subjects had shorter total sleep time ( TST ) and rapid eye movement ( REM ) sleep , longer sleep onset latency , more light sleep and awakening , poorer subjective sleep quality , higher anxiety level and lower serum melatonin level in NL night ( P < 0.05 ) . NLEE had less awakenings and shorter sleep onset latency ( P < 0.05 ) . NLM had longer TST and REM and shorter sleep onset latency ( P < 0.05 ) . Compared with NLEE , NLM had fewer awakenings ( P = 0.004 ) . Both NLM and NLEE improved perceived sleep quality and anxiety level ( P = 0.000 ) , and NLM showed better than NLEE in perceived sleep quality ( P = 0.01 ) . Compared to baseline night , the serum melatonin levels were lower in NL night at every time point , and the average maximal serum melatonin concentration in NLM group was significantly greater than other groups ( P < 0.001 ) . Conclusions Compared with earplugs and eye masks , melatonin improves sleep quality and serum melatonin levels better in healthy subjects exposed to simulated ICU noise and light . Trial registration Chinese Clinical Trial Registry ChiCTR-IPR-14005458 . Registered 10 November 2014 STUDY OBJECTIVES To objective ly measure sleep in critically ill patients requiring mechanical ventilation and to define selection criteria for future studies of sleep continuity in this population . DESIGN Prospect i ve cohort analysis . SETTING University teaching hospital medical-surgical ICU . PATIENTS Twenty critically ill ( APACHE II [ acute physiology and chronic health evaluation II ] acute physiology score [ APS ] , 10 + /- 5 ) , mechanically ventilated adults ( male 12 , female 8 , age 62 + /- 15 years ) with mild to 
    Output:
    
Most of the review ed studies showed a significant improvement of subjective sleep quality when using described non-pharmacological interventions ( objective parameters were not significantly vali date d ) .
Despite the heterogeneity of analysed studies and some common method ological issues ( sample size , design , outcome parameters choice and comparison ) earplugs and eye mask showed potential positive effects on sleep quality and the incidence of delirium in ICU patients