Earplugs Are Effective in Reducing Risk of Delirium

A systematic review of the use of earplugs to reduce delirium in intensive care patients has found that they significantly reduce the risk of delirium. The review, by Edward Litton, Department of Intensive Care Medicine, St John of God Hospital Subiaco, Australia and colleagues is published in Critical Care Medicine.

The review analysed data from 9 studies published between 2009 and 2015, which included a total of 1,455 participants. The studies included those that used earplugs alone as the intervention as well as studies that looked at earplugs as part of a bundle with eye shades or with other sleep noise reduction strategies. The reviewers note that the risk of bias was high for all studies.

See Also: Sleep in the ICU: Cochrane Review of Non-Drug Interventions

5 of the studies (832 participants) reported incident delirium. A relative risk of delirium of 0.59 (95% CI, 0.44-0.78) was associated with earplug use.

The reviewers conclude that earplug use either on its own or as part of a sleep bundle, is associated with reduced risk of delirium. They note that uncertainty remains on the potential effect of interventions used along with earplugs. As delirium is multifactorial the best strategy for improving sleep and ultimate effect on outcomes is still unresolved.

Image credit: Wikimedia Commons


Litton E, Carnegie V, Elliott R, Webb SAR (2016) The efficacy of earplugs as a sleep hygiene strategy for reducing delirium in the ICU: a systematic review and meta-analysis. Crit Care Med, Jan 6. [Epub ahead of print]

Published on : Mon, 25 Jan 2016

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Earplugs, Sleep, Critically ill, ICU Summary of a systematic review on the effects of earplugs in reducing the risk of delirium in patients in the intensive care unit

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