Non-Pharmacological Sleep Interventions after Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Sueyeon Lee, Pei Chen, Chang Park and 2 others
PMID 39632467WHAT IT FOUND
Non-drug sleep interventions after cardiac surgery improved patient-reported sleep quality, but sleep duration did not show a clear improvement.
The evidence is low quality and very varied, so no single technique is proven best.
Key findings
01Across 27 trials, pooled sleep scores favoured non-drug interventions, with effect sizes the authors called medium to large.
02Sleep quality improved in the pooled outcome analysis, but sleep duration did not reach statistical significance.
03Subgroup analysis by intervention type showed human resource-based strategies had the largest pooled effect, but physiotherapy and device studies were too few to analyse.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The overall quality of evidence was low, mainly because of risk-of-bias concerns and inconsistency across trials. Most trials used patient-reported sleep scores, and only two used an objective actigraphy measure, so expectations and unblinding could influence results. Only 27 of 37 trials could be pooled, and the remaining 10 did not report enough data. Heterogeneity was very high, and subgroup analyses could not examine physiotherapy or device use because there were too few studies. Publication bias was suspected for regular-scored outcomes, and many trials had some concerns about randomisation, blinding, or selective reporting. Interventions varied widely in type, setting, timing, and duration, so the pooled result cannot identify the best intervention.
Declared interests
The authors declared no conflicts of interest. Funding was from the U.S. National Institute on Minority Health and Health Disparities at the National Institutes of Health to BB.
The easy way to misread this
Do not read the pooled effect as proof that any one non-drug technique works. The trials used many different interventions, were mostly self-reported, had high heterogeneity and low GRADE evidence, and sleep duration was not significantly improved.