收稿日期: 2024-03-20
网络出版日期: 2025-01-14
基金资助
2022年浦东新区卫生健康委员会卫生科研项目(PW2022B-12)
Meta-analysis of the effect of white noise on sleep in ICU patients
目的 采用Meta分析的方法系统评价白噪声对ICU患者睡眠质量的影响。方法 通过计算机检索CINAHL、PubMed等11个数据库中关于白噪声对急危重症患者睡眠质量影响的文献，检索时间为建库至2024年3月11日。由2名研究者独立进行文献筛选、资料提取和偏倚风险评估后，采用RevMan 5.4软件对纳入文献进行Meta分析。结果 最终9篇文献、792例研究对象被纳入研究，Meta分析结果显示，白噪声可以改善ICU患者睡眠[MD=-4.63，95%CI（-7.11，-2.14），P<0.001]，加快入睡速度[MD=21.82，95%CI（8.14，35.50），P<0.001]，提高睡眠深度[MD=19.18，95%CI（7.05，31.31），P<0.001]，减少夜间觉醒次数[MD=20.36，95%CI（6.46，34.26），P<0.001]，加快再入睡[MD=23.72，95%CI（9.22，38.22），P<0.001]，提高睡眠质量[MD=21.66，95%CI（8.07，35.25），P<0.001]，降低噪声水平[MD=29.27，95%CI（10.74， 47.79），P<0.001]，可以延长患者睡眠时长，能减轻患者焦虑[MD=-8.11，95%CI（-10.55，-5.68），P<0.001]和抑郁[MD= -5.86，95%CI（-8.76，-2.96），P<0.001]。结论 白噪声可以明显改善ICU患者睡眠状况和减轻患者焦虑、抑郁等负面情绪，但纳入研究的文献质量较低，研究间异质性较高，需大样本、设计严谨、高质量的随机对照试验进一步证实。
王海燕 , 杜锦萍 , 张金换 , 沈晓玲 , 陶燕 , 江萍 . 白噪声对ICU患者睡眠影响的Meta分析[J]. 中华急危重症护理杂志, 2025 , 6(1) : 57 -64 . DOI: 10.3761/j.issn.2096-7446.2025.01.008
Objective To systematically evaluate the effect of white noise on sleep quality of ICU patients by meta-analysis. Methods The studies on the effects of white noise on sleep quality in critically ill patients were searched by computer from 11 databases，including CINAHL and PubMed. The search limit was from the inception of the database to March 11，2024. Two researchers independently screened literature，extracted data and assessed the risk of bias. RevMan 5.4 software was used for meta-analysis. Results A total of 9 studies involving 792 subjects were included in the study. The results of meta-analysis showed that white noise could improve sleep in ICU patients[MD=-4.63，95%CI（-7.11，-2.14），P<0.001]，accelerate the speed of falling asleep[MD=21.82，95%CI（8.14，35.50），P<0.001]，and improve sleep depth[MD=19.18，95%CI（7.05，31.31），P<0.001]，reduce the number of nocturnal awakenings[MD=20.36，95%CI（6.46，34.26），P<0.001]，accelerate re-falling asleep[MD=23.72，95%CI（9.22， 38.22），P<0.001]，improve sleep quality[MD=21.66，95%CI（8.07，35.25），P<0.001]，reduced noise level[MD=29.27， 95%CI（10.74，47.79），P<0.001]. White noise could prolong patients’ sleep duration，and reduce patients’ anxiety[MD=-8.11，95%CI（-10.55，-5.68），P<0.001] and depression[MD=-5.86，95%CI（-8.76，-2.96），P<0.001]. Conclusion White noise can significantly improve the sleep status of ICU patients and reduce negative emotions such as anxiety and depression，but the quality of the included studies is low，and the heterogeneity between studies is high，which needs to be further confirmed by large-sample，well-designed and high-quality randomized controlled trials.
| [1] | Chaudhary A, Kumari V, Neetu N. Sleep promotion among critically ill patients:earplugs/eye mask versus ocean sound:a ran-domized controlled trial study[J]. Crit Care Res Pract, 2020, 2020:8898172. |
| [2] | Auckley D. Poor sleep and insomnia during hospitalization in adults. UpToDate clinical adviser[EB/OL]. (2023-05-22)[2024-03-11]. https://www.uptodate.cn/contents/zh-Hans/poor-sleep-and-insomnia-in-hospitalized-adults. |
| [3] | Elías MN, Munro CL, Liang Z. Sleep quality associated with motor function among older adult survivors of critical illness[J]. Nurs Res, 2020, 69(4):322-328. |
| [4] | 魏月清, 李红, 李芸, 等. ICU后认知障碍风险预测模型的构建及验证[J]. 中华护理杂志, 2021, 56(1):14-20. |
| Wei YQ, Li H, Li Y, et al. Construction of a risk prediction model for post-intensive care syndrome-cognitive impairment[J]. Chin J Nurs, 2021, 56(1):14-20. | |
| [5] | Kamble N, Yadav R, Lenka A, et al. Impaired sleep quality and cognition in patients of Parkinson’s disease with REM sleep behavior disorder:a comparative study[J]. Sleep Med, 2019,62:1-5. |
| [6] | 麦瑶, 李皓桓, 胡金凤. 白噪音对全膝关节置换术病人心理状态和睡眠质量的影响[J]. 临床外科杂志, 2022, 30(6):589-591. |
| Mai Y, Li HH, Hu JF. Effects of white noise on psychological status and sleep quality in patients undergoing total knee arthroplasty[J]. J Clin Surg, 2022, 30(6):589-591. | |
| [7] | 任向芳, 杨梅. 白噪声疗法在新生儿临床护理中的应用现状[J]. 护理研究, 2021, 35(1):125-128. |
| Ren XF, Yang M. Application status quo of white noise therapy in clinical nursing of newborn[J]. Chin Nurs Res, 2021, 35(1):125-128. | |
| [8] | Riedy SM, Smith MG, Rocha S, et al. Noise as a sleep aid:a systematic review[J]. Sleep Med Rev, 2021,55:101385. |
| [9] | Liao JH, Liu GH, Xie NM, et al. Mothers’ voices and white noise on premature infants’ physiological reactions in a neonatal intensive care unit:a multi-arm randomized controlled trial[J]. Int J Nurs Stud, 2021,119:103934. |
| [10] | Yang J, Weng LZ, Chen ZK, et al. Development and testing of a mobile app for pain management among cancer patients discharged from hospital treatment:randomized controlled trial[J]. JMIR Mhealth Uhealth, 2019, 7(5):e12542. |
| [11] | 位新红, 张倩, 赵静, 等. 白噪声降噪耳塞联合眼罩对ICU患者睡眠质量的影响[J]. 中国实用护理杂志, 2022, 38(10):747-752. |
| Wei XH, Zhang Q, Zhao J, et al. Effect of white noise reduction earplugs combined with eye mask on sleep quality of ICU patients[J]. Chin J Pract Nurs, 2022, 38(10):747-752. | |
| [12] | 王燕, 戴梦霞, 狄忆莲. 白噪声联合早期目标导向镇静策略在危重症机械通气患者中的应用效果[J]. 临床护理杂志, 2022, 21(3):38-41. |
| Wang Y, Dai MX, Di YL. Application effect of white noise combined with early goal-oriented sedation strategy in critically ill patients with mechanical ventilation[J]. J Clin Nurs, 2022, 21(3):38-41. | |
| [13] | 牛阳. 急诊监护室中白噪声对患者睡眠质量的影响研究[J]. 世界睡眠医学杂志, 2021, 8(1):151-152. |
| Niu Y. Study on the effect of white noise in emergency care room on patients’ sleep quality[J]. World J Sleep Med, 2021, 8(1):151-152. | |
| [14] | 张洁. 简析急诊监护室中白噪声对患者睡眠质量的影响[J]. 养生保健指南, 2020(38):43. |
| Zhang J. Effect of white noise on sleep quality of patients in emergency intensive care unit[J]. Health Care Guidelines, 2020(38):43. | |
| [15] | 邵乐文, 黄丽华, 黄夏薇, 等. 白噪音对ICU患者睡眠质量的影响[J]. 中华危重症医学杂志(电子版), 2018, 11(4):286-288. |
| Shao LW, Huang LH, Huang XW, et al. Effect of white noise on sleep quality of ICU patients[J]. Chin J Crit Care Med Electron Ed, 2018, 11(4):286-288. | |
| [16] | 唐晶晶, 王萍. 急诊监护室中白噪声对患者睡眠质量的影响[J]. 中华现代护理杂志, 2017, 23(13):1774-1776. |
| Tang JJ, Wang P. Effect of white noise on sleep in emer-gency intensive care unit patients[J]. Chin J Mod Nurs, 2017, 23(13):1774-1776. | |
| [17] | Farokhnezhad AP, Bahramnezhad F, Asgari P, et al. Effect of white noise on sleep in patients admitted to a coronary care[J]. J Caring Sci, 2016, 5(2):103-109. |
| [18] | 连小勤, 关风光, 林兰, 等. 海洋声音对ICU清醒患者夜间睡眠质量及负性情绪的影响[J]. 中华现代护理杂志, 2015(32):3885-3887. |
| Lian XQ, Guan FG, Lin L, et al. Effects of ocean sound on nocturnal sleep quality and negative emotion among the ICU awake patients[J]. Chin J Mod Nurs, 2015(32):3885-3887. | |
| [19] | Hu RF, Jiang XY, Hegadoren KM, et al. Effects of earplugs and eye masks combined with relaxing music on sleep,melatonin and cortisol levels in ICU patients:a randomized controlled trial[J]. Crit Care, 2015, 19(1):115. |
| [20] | 张娟, 罗翊, 吴慧芳. 白噪音干预对混合性焦虑抑郁障碍患者睡眠质量的影响[J]. 长江大学学报(自然科学版), 2019, 16(11):131-133. |
| Zhang J, Luo Y, Wu HF. Effect of white noise intervention on sleep quality of patients with mixed anxiety and depression disorder[J]. J Yangtze Univ Nat Sci Ed, 2019, 16(11):131-133. | |
| [21] | Liao JH, Hu RF, Su LJ, et al. Nonpharmacological interventions for sleep promotion on preterm infants in neonatal intensive care unit:a systematic review[J]. Worldviews Ev Based Nurs, 2018, 15(5):386-393. |
| [22] | 卢美枚, 裴清华, 许芳, 等. 失眠患者睡眠质量与心理健康状况的相关性研究[J]. 世界中医药, 2020, 15(8):1210-1213. |
| Lu MM, Pei QH, Xu F, et al. Study on the correlation between sleep quality and mental health of insomniacs[J]. World Chin Med, 2020, 15(8):1210-1213. | |
| [23] | Ohbayashi W, Kakigi R, Nakata H. Effects of white noise duration on somatosensory event-related potentials[J]. Neuroreport, 2019, 30(1):26-31. |
| [24] | Mizukami H, Kakigi R, Nakata H. Effects of stimulus intensity and auditory white noise on human somatosensory cognitive processing:a study using event-related potentials[J]. Exp Brain Res, 2019, 237(2):521-530. |
| [25] | 翁丽娜, 崔益鸿, 徐玮. 白噪音干预对于长期血透患者疲乏状态的影响[J]. 海军医学杂志, 2018, 39(5):465-467. |
| Weng LN, Cui YH, Xu W. Effect of white noise intervention on fatigue of long-term hemodialysis patients[J]. J Navy Med, 2018, 39(5):465-467. |
/
| 〈 |
|
〉 |