Integrative therapies to promote sleep in the intensive care unit

The prevalence of sleep pattern disturbances (SPDs) in the ICU has been linked to a myriad of factors (e.g., pathologic state, care processes, ICU environment) and unfavorable outcomes such as amplification of stress, immune and inflammatory function in an already altered homeostatic state of critically ill patients resulting in delayed recovery from illness or injury, reduced health-related quality of life and care satisfaction, and among others. Health risk factors and causes of sleep disruptions in patient's sleep/wake pattern in the ICU have been long recognized. However, little effort has been done on promoting sleep among patients in the ICU specifically using nonpharmacologic agents such as integrative therapies. This chapter provides the reader with overview of sleep disturbances the ICU and appraisal of the available knowledge on several integrative therapies that have been investigated and implemented as sleep-promoting interventions in the ICU. Because of the little emphasis on sleep promotion, complexity of patients, difficulty in measuring sleep, and integrating nonpharmacologic sleep interventions in the usual care, strong and high-quality evidence supporting the utilization of integrative therapies is lacking. Implications to clinical practice and research are discussed.