***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 The aim of the present prospect i ve multicenter cohort study was to examine the prevalence of sleep disturbance and its relation to the patient 's reported health-related quality of life  after intensive care . We also assessed the possible underlying causes of sleep disturbance , including factors related to the critical illness . Methods Between August 2000 and November 2003 we included 1,625 consecutive patients older than 17 years of age admitted for more than 24 hours to combined medical and surgical intensive care units ( ICUs ) at three hospitals in Sweden . Conventional intensive care variables were prospect ively recorded in the unit data base . Six months and 12 months after discharge from hospital , sleep disturbances and the health-related quality of life were evaluated using the Basic Nordic Sleep Question naire and the Medical Outcomes Study 36-item Short-form Health Survey , respectively . As a nonvali date d single-item assessment , the quality of sleep prior to the ICU period was measured . As a reference group , a r and om sample ( n = 10,000 ) of the main intake area of the hospitals was used . Results The prevalence of self-reported quality of sleep did not change from the pre-ICU period to the post-ICU period . Intensive care patients reported significantly more sleep disturbances than the reference group ( P < 0.01 ) . At both 6 and 12 months , the main factor that affected sleep in the former hospitalised patients with an ICU stay was concurrent disease . No effects were related to the ICU period , such as the Acute Physiology and Chronic Health Evaluation score , the length of stay or the treatment diagnosis . There were minor correlations between the rate and extent of sleep disturbance and the health-related quality of life . Conclusion There is little change in the long-term quality of sleep patterns among hospitalised patients with an ICU stay . This applies both to the comparison before and after critical care as well as between 6 and 12 months after the ICU stay . Furthermore , sleep disturbances for this group are common . Concurrent disease was found to be most important as an underlying cause , which emphasises that it is essential to include assessment of concurrent disease in sleep-related research in this group of patients 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 OBJECTIVE To test the efficacy of music and muscle relaxation techniques in reducing the anxiety of patients admitted to a coronary care unit with ischemic heart disease . DESIGN R and omized , controlled trial . SETTING Seven-bed coronary care unit of an Australian tertiary care hospital . PATIENTS Fifty-six patients admitted to a coronary care unit with unstable angina pectoris or acute myocardial infa rct ion . OUTCOME MEASURES Psychologic ( State Trait Anxiety Inventory , Hospital Anxiety and Depression Scale , Linear Analogue Anxiety Scale ) and physiologic ( systolic and diastolic blood pressure and heart rate ) variables were measured as indicators of anxiety . INTERVENTION Two or three 30-minute sessions of audiotape interventions were conducted with portable tape players with headphones . The two intervention tapes consisted of light classical music and verbal instructions for muscle relaxation . RESULTS With analysis of variance procedures , the null hypotheses were supported . No significant differences ( p < 0.05 ) between groups were demonstrated for the psychologic or physiologic variables ; that is , no significant reductions in anxiety were achieved for patients using music or muscle relaxation interventions when compared with the control group . The effect size of the interventions on the outcome measures was 0.19 to 0.22 , indicating a small effect . Result ant power was at a low level . CONCLUSIONS These results differ from those of similar studies but may be related to the high probability of a type II error . Further investigation with longer intervention sessions and larger sample sizes is indicated . Similar studies should incorporate power analysis when reporting their results Objectives : To compare the influence of three ventilatory modes on sleep . Design : Prospect i ve , comparative , crossover study . Setting : Medical intensive care unit in a university hospital . Patients : Fifteen conscious , nonse date d , mechanically ventilated patients . Interventions : Patients were successively ventilated with assist-control ventilation , clinical ly adjusted pressure support ventilation ( cPSV ) , and automatically adjusted pressure support ventilation ( aPSV ) . Sleep polysomnography  was performed during three consecutive 6-hr periods , one with each mode in r and om order . Airway pressure and thorax and abdomen plethysmography were used to diagnose central apneas and ineffective efforts . Measurements and Main Results : The main abnormalities were a low percentage of rapid eye movement ( REM ) sleep counting , for a median ( 25th–75th percentiles ) of 10 % ( 3.5–12.5 ) of total sleep , and a highly fragmented sleep with 29 arousals and awakenings per hour of sleep . REM sleep duration was similar in the three ventilatory modes , 7 % in assist-control , 4 % in aPSV , and 1 % during cPSV ( p = .54 ) , as well as in the fragmentation index , 31 arousals and awakenings per hour in assist-control , 32 in aPSV , and 34 during cPSV ( p = .62 ) . Ineffective efforts occurred similarly with the three modes ( seven per hour of sleep in assist-control , 16 in aPSV , and 12 during cPSV ) or central apneas during PSV ( five in aPSV , seven during cPSV ) . Minute ventilation was similar with the three modes . Conclusions : In conscious , mechanically ventilated patients , sleep architecture was highly abnormal , with a short REM stage and a high degree of fragmentation . The ventilatory mode did not influence sleep pattern , arousals , awakenings , and ineffective efforts PURPOSE The purpose of this research was to analyze the effects of an eye protective device and ear protective device application on  sleep disorder with coronary disease patients in CCU . METHODS The research design was set up as a nonequivalent control group non-synchronized design . The subjects were coronary disease patients in the CCU of a tertiary hospital . The subjects were composed of 20 in the group with an eye protective device , 18 in the group with an ear protective device , 17 in the group with an eye protective device and ear protective device and 20 in the control group .  The data was analyzed by chi2-test , ANOVA , Repeated measures ANOVA , Sheffe-test , Simple main effect and Time contrast using SPSS Win 12.0 . RESULTS The hypothesis , ' There are significant differences in sleep quantity among the four groups ' was supported ( F=1,342.71 , p=.000 ) . The hypothesis , ' There are significant differences in the subjective evaluation of the general sleep patterns among the four groups ' was supported ( F=3,638.73 , p=.000 ) . In addition the hypothesis , ' There are significant differences in degree of sleep among the four groups ' was supported ( F=1,616.61 , p=.000 ) . CONCLUSION It is cost effective and a simple eye protective device and ear protective device should be applied to patients according to their preference and characteristics in the clinical setting 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 The efficacy of complementary and alternative therapies for sleep promotion in critically ill patients is largely unexamined . We found only seven studies ( three on environmental interventions and one each on massage , music therapy , therapeutic touch , and , melatonin ) that examined the effect of complementary and alternative therapies . A number of studies , however , have shown that massage , music therapy . and therapeutic touch promote relaxation and comfort in critically ill patients , which likely leads to improved sleep .  Massage , music therapy , and therapeutic touch are safe for critically ill patients and should be routinely applied by ICU nurses who have received training on how to administer these specialized interventions . Environmental interventions , such as reducing noise , playing white noise such as ocean sounds , and decreasing interruptions to sleep for care , also are safe and logical interventions that ICU nurses should use to help patients sleep . Progressive muscle relaxation has been extensively studied and shown to be efficacious for improving sleep in persons with insomnia ; however , progressive muscle relaxation requires that patients consciously attend to relaxing specific muscle groups and practice these techniques , which may be difficult for critically 11 patients . We do not currently recommend aromatherapy and alternative sedatives , such as valerian and melatonin , for sleep promotion in critically ill patients because the safety of these substances is unclear . In summary , we recommend that ICU nurses implement music therapy , environmental interventions , therapeutic touch , and relaxing massage to promote sleep in critically ill patients . These interventions are safe and may improve patient sleep , although r and omized controlled trials are needed to test their efficacy . Aromatherapy and alternative sedatives require further investigation to determine their safety and efficacy 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 
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No studies examined the effect of any non-pharmacological intervention on mortality , risk of post-traumatic stress disorder , or cost-effectiveness ; the included studies did not clearly report adverse effects , although there was very low quality evidence that ventilator mode influenced the incidence of central apnoeas and patient-ventilator asynchronies .