A Meta-analysis of Sleep-promoting Interventions During XXXX .

@entity1 @entity3124 @entity1949 @entity15131
BACKGROUND: Sleep quality and quantity are severely reduced in @entity3124 @entity1 receiving mechanical ventilation with a potential for adverse consequences. Our objective was to synthesize the randomized controlled trials (RCTs) that measured the efficacy of sleep-promoting interventions on sleep quality and quantity in @entity3124 @entity1 . METHODS: We included RCTs that objectively measured sleep with electroencephalography or its derivatives and excluded observational studies and those that measured sleep by subjective reports. The research was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Of 6022 studies identified, 13 met eligibility criteria involving 296 @entity3124 @entity1 . Eight trials looked at different modes of mechanical ventilation as sleep interventions, and the remaining 5  involved pharmacologic, nonpharmacologic, or environmental interventions. Meta-analysis of the studies revealed that sleep-promoting interventions improved sleep quantity (pooled standardized mean difference [SMD], 0.37; 95% confidence interval [CI], 0.05-0.69; P  = .02) and sleep quality through reduction in @entity1949 (SMD,  -0.31; 95% CI,  -0.60 to  -0.01; P  = .04). Subgroup analysis revealed that timed modes of ventilation improved sleep quantity when compared with @entity15131 (SMD, 0.45; 95% CI, 0.10-0.81; P  = .01). Nonmechanical ventilation interventions tended to improve sleep quantity (SMD, 0.65; 95% CI,  -0.03 to 1.33; P  = .06) and to reduce @entity1949 (SMD,  -0.29; 95% CI,  -0.61 to 0.03; P  = .07). CONCLUSIONS: The synthesized evidence suggests that both mechanical ventilation- and nonmechanical ventilation-based therapies improve sleep quantity and quality in @entity3124 @entity1 , but the clinical significance is unclear. In the future, adequately powered multicenter RCTs involving pharmacologic interventions to promote sleep in @entity3124 @entity1 are warranted.
