The Effect of Use of Earplugs on Sleep Quality in Coronary Care Units Patients

Sleep deprivation along with subsequent increased blood pressure and heart rate can lead to higher risk among patients admitted to Coronary Care Units (CCUs). The aim of this study was to determine the effect of use of earplugs on sleep quality and its domains (sleep disturbance, supplementary sleep and the effectiveness of sleep) in CCU patients. This cross-over randomized clinical trial study was carried out on 92 CCU patients in 2 groups of A (using earplugs at the first night and no earplugs at the second night) and B (no earplugs at the first night and using earplugs at the second night). Data collection was done using a two-part tool including a researcher-made questionnaire on individual and socio-demographic information related to disease and standard scale of Verran and Snyder-Halpern Sleep Scale (VSH Sleep Scale). Earning higher scores was described as poor sleep quality in the overall quality of sleep and its domains. Data analysis was performed using descriptive and inferential statistical methods, ANOVA and Generalized Estimating Equations (GEE) logistic regression. The results revealed that the female participants made up the majority of samples in both groups A and B (54.2 and 60.4%). The use of earplugs significantly reduced the quality of sleep disturbance domain in both groups A and B (P=0.0001 and P=0.021, respectively), and the supplementary sleep domain in group A (P=0.027). There was no significant difference between the two groups in terms of mean change in overall sleep quality score and its domains within the two nights. Finally, the GEE-based regression test based on controlling the individual and social and disease-associated factors indicates the effect of use of earplugs in reducing the quality of sleep (B=3.1 and P=0.0001) and its domains, including sleep disturbance (B=-5.59 and P=0.021), supplementary sleep (B=3.33 and P=0.0001) and sleep effectiveness (B=-1.43 and P=0.027). The negative effects of using earplugs on overall sleep quality and its domains in this study highlights the need to carry out further researches in order to find an effective method to improve sleep quality in CCU patients.