The efficacy of nursing interventions on sleep quality in hospitalized patients: A systematic review of randomized controlled trials

Int J Nurs Stud. 2021 Mar:115:103855. doi: 10.1016/j.ijnurstu.2020.103855. Epub 2020 Dec 14.


Objective: To determine the effect of interventions that could be performed by nurses to improve the sleep quality of hospitalized patients in acute and semi-acute units.

Design: A systematic review of randomized controlled trials and narrative synthesis.

Data sources: Seven electronic databases (PubMed, CINAHL Plus, Scopus, ISI WoS, CENTRAL, PsycInfo, and Embase) were accessed on 20 May 2019 with a temporal limit of 10 years prior.

Review methods: Original research studies of interventions that could be delivered by nurses to improve sleep quality during hospitalization in acute and semi-acute units were included. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers.

Results: Seventeen studies met the inclusion criteria and were included in this review. The interventions carried out in the trials were classified into four categories of measurement: environmental, physical, behavioural, and combined. Fourteen studies obtained statistically significant improvements; two showed a blend of significant and non-significant improvements; and one reported non-significant results. However, only four trials of the seventeen were judged as having a low risk of bias.

Conclusions: Overall evidence about interventions that could be performed by nurses to improve perceived sleep quality in hospitalized patients was found to be positive, and no negative effects were reported. However, higher quality research using both subjective and objective measures is needed, in order to strengthen the evidence.

Keywords: Circadian rhythm; Hospitalization; Nursing; Randomized control trial; Sleep; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Hospitalization*
  • Humans
  • Randomized Controlled Trials as Topic
  • Sleep*