Abstract
Background: Sleep disturbance is highly prevalent among critically ill patients. In the intensive care unit (ICU), multiple environmental and care-related factors disrupt sleep. We tested a multicomponent, technology-assisted SLEEP program designed to target modifiable contributors to poor sleep.
Objective: To evaluate the effectiveness of the SLEEP program on sleep disturbances in adults admitted to a surgical ICU.
Methods: In this assessor-blinded, parallel-group randomized controlled trial, 108 surgical ICU patients were randomized 1:1 to the technology-assisted SLEEP program (n = 54) or routine care (n = 54). The SLEEP group received a nightly multicomponent intervention for up to three consecutive days during the ICU stay and a 30-minute virtual-reality relaxation session before bedtime each night. The routine care group received standard ICU care, including eye-mask use. Primary outcomes were subjective sleep quality (Richards–Campbell Sleep Questionnaire, RCSQ) and objective sleep stages assessed by electroencephalography on the first day after the intervention and again prior to ICU discharge. Secondary outcomes were anxiety, stress, and pain (visual analog scales) measured at the first day after intervention, hospital discharge, and 1 and 6 months post-discharge, and autonomic function indexed by heart rate variability (HRV) on the first day after intervention and prior to ICU discharge. Analyses used appropriate comparative statistics with significance set at p < .05.
Results: Compared with routine care, the SLEEP group demonstrated significantly higher total RCSQ scores and improvements across all subscales—sleep depth, sleep latency, number of awakenings, sleep efficiency, and overall sleep quality (all p < .05). On electroencephalography, the SLEEP group showed a lower proportion of stage 2 sleep (29.93% vs. 42.75%) and a higher proportion of stage 3 sleep (22.15% vs. 13.51%) relative to routine care (both p < .05). Anxiety scores were significantly lower in the SLEEP group, and the low-frequency component of HRV exhibited an increasing trend over time.
Conclusion: A short, technology-assisted, multicomponent SLEEP program improved subjective sleep quality and deep sleep and reduced anxiety in critically ill surgical patients, supporting the feasibility and clinical value of structured sleep-promotion protocols in the surgical ICU.
Notes
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References:
Shih, C. Y., Gordon, C. J., Chen, T. J., Phuc, N. T., Tu, M. C., Tsai, P. S., & Chiu, H. Y. (2022, Jun). Comparative efficacy of nonpharmacological interventions on sleep quality in people who are critically ill: A systematic review and network meta-analysis. Int J Nurs Stud, 130, 104220. https://doi.org/10.1016/j.ijnurstu.2022.104220
Shih, C. Y., Wang, A. Y., Chang, K. M., Yang, C. C., Tsai, Y. C., Fan, C. C., Chuang, H. J., Thi Phuc, N., & Chiu, H. Y. (2023, Apr). Dynamic prevalence of sleep disturbance among critically ill patients in intensive care units and after hospitalisation: A systematic review and meta-analysis. Intensive Crit Care Nurs, 75, 103349. https://doi.org/10.1016/j.iccn.2022.103349
Sigma Membership
Lambda Beta at-Large
Lead Author Affiliation
Taipei Medical University, Taipei, Taiwan, ROC
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Randomized Controlled Trial
Research Approach
Quantitative Research
Keywords:
Acute Care, Sleep Quality, Critically Ill Patients, Intensive Care Units, Virtual Reality
Recommended Citation
Chiu, Hsiao-Yean and Shih, Chun-Ying, "Technology-Assisted SLEEP Program for Improving Sleep in Critically Ill Surgical Patients" (2026). International Nursing Research Congress (INRC). 76.
https://www.sigmarepository.org/inrc/2026/presentations_2026/76
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-27
Technology-Assisted SLEEP Program for Improving Sleep in Critically Ill Surgical Patients
Toronto, Ontario, Canada
Background: Sleep disturbance is highly prevalent among critically ill patients. In the intensive care unit (ICU), multiple environmental and care-related factors disrupt sleep. We tested a multicomponent, technology-assisted SLEEP program designed to target modifiable contributors to poor sleep.
Objective: To evaluate the effectiveness of the SLEEP program on sleep disturbances in adults admitted to a surgical ICU.
Methods: In this assessor-blinded, parallel-group randomized controlled trial, 108 surgical ICU patients were randomized 1:1 to the technology-assisted SLEEP program (n = 54) or routine care (n = 54). The SLEEP group received a nightly multicomponent intervention for up to three consecutive days during the ICU stay and a 30-minute virtual-reality relaxation session before bedtime each night. The routine care group received standard ICU care, including eye-mask use. Primary outcomes were subjective sleep quality (Richards–Campbell Sleep Questionnaire, RCSQ) and objective sleep stages assessed by electroencephalography on the first day after the intervention and again prior to ICU discharge. Secondary outcomes were anxiety, stress, and pain (visual analog scales) measured at the first day after intervention, hospital discharge, and 1 and 6 months post-discharge, and autonomic function indexed by heart rate variability (HRV) on the first day after intervention and prior to ICU discharge. Analyses used appropriate comparative statistics with significance set at p < .05.
Results: Compared with routine care, the SLEEP group demonstrated significantly higher total RCSQ scores and improvements across all subscales—sleep depth, sleep latency, number of awakenings, sleep efficiency, and overall sleep quality (all p < .05). On electroencephalography, the SLEEP group showed a lower proportion of stage 2 sleep (29.93% vs. 42.75%) and a higher proportion of stage 3 sleep (22.15% vs. 13.51%) relative to routine care (both p < .05). Anxiety scores were significantly lower in the SLEEP group, and the low-frequency component of HRV exhibited an increasing trend over time.
Conclusion: A short, technology-assisted, multicomponent SLEEP program improved subjective sleep quality and deep sleep and reduced anxiety in critically ill surgical patients, supporting the feasibility and clinical value of structured sleep-promotion protocols in the surgical ICU.
Description
Sleep disturbance is common in surgical ICUs. In an assessor-blinded RCT (N=108), adults received either a technology-assisted SLEEP program (up to 3 nightly sessions plus 30-min pre-bed VR relaxation) or routine care with eye masks. The SLEEP arm had higher Richards–Campbell Sleep Questionnaire scores, less stage 2 and more stage 3 (deep) sleep on EEG (all p<.05), lower anxiety, and rising HRV LF power. A brief tech-supported bundle is feasible and improves sleep and anxiety.