Comparing the Efficacy of Earplugs and Eye Masks on Pain and Sleep Quality in Cardiovascular Intensive Care Unit Patients: A Three‐Arm Randomised Controlled Trial

BACKGROUND: Cardiovascular diseases are among the most common and leading causes of death worldwide. Surgical methods such as coronary artery bypass graft surgery (CABG) provide successful results in this process. Patients who are faced with these disturbing life-threatening experiences try to cope with many problems until the discharge process. The most common of these problems in the postoperative period is pain and insomnia. In the literature, there have been studies to determine the effect of eye mask and earplug on sleep and pain level; however, there are no studies examining the superiority of earplugs or eye masks over each other. AIM: To determine the superiority of earplugs and eye masks to each other and their efficacy in pain and sleep quality. STUDY DESIGN: The study was a three-arm randomised controlled trial. METHODS: After a baseline assessment, participants were randomly assigned to three groups. The random assignment was performed by using a computer program. Afterwards, participants were categorised into three groups. Group 3 patients in this group did not receive any treatment to improve pain and sleep quality during the study period. Routine postoperative care was applied in the clinic (n = 30). Group 2 was given the earplug (n = 30), whereas Group 1 was given the eye mask (n = 30). RESULTS: Statistically significant differences were found between the three groups in terms of sleep depth, sleep onset latency, number of awakenings, sleep efficiency, sleep quality, total Richard-Campbell Sleep Questionnaire (RCSQ) score and visual analogue scale (VAS) scores (p = 0.000) in total 90 participants participated, 30 in each group. The group that used an eye mask (Group 1) and the group that used earplugs (Group 2) had higher mean values than the control group (Group 3) in terms of sleep depth, sleep onset latency, sleep efficiency, sleep quality and total RCSQ score. The mean total RCSQ scores were 61.4 ± 3.7 in Group 1, 62.8 ± 5.0 in Group 2 and 46.5 ± 4.6 in Group 3. Accordingly, the mean difference was calculated as 14.9 points (95% CI: 12.8-17.0; p = 0.000) between Group 1 and Group 3 and 16.3 points (95% CI: 13.9-18.7; p = 0.000) between Group 2 and Group 3. Furthermore, VAS scores measured in the morning showed lower mean values in Group 1 (VAS: 4.4 ± 0.7) and Group 2 (VAS: 4.2 ± 0.8) compared to the control group (VAS: 6.3 ± 1.0) (p = 0.000). No statistically significant difference was found between the eye mask and earplug groups in terms of RCSQ subscales, total RCSQ score and VAS scores (p > 0.05). CONCLUSION: Promoting sleep in intensive care unit (ICU) patients is crucial for recovery. Simple, non-pharmacological interventions like eye masks and earplugs improve sleep quality and comfort, especially after cardiac surgery. These cost-effective strategies reduce sleep disturbances and enhance patient well-being, highlighting the importance of prioritising restorative sleep in critical care. RELEVANCE TO CLINICAL PRACTICE: Improving sleep quality in ICU patients is essential for postoperative recovery. This study highlights that simple, cost-effective interventions like eye masks and earplugs can enhance sleep and comfort in patients undergoing cardiac surgery. Integrating these non-pharmacological strategies into routine nursing care can help reduce sleep disturbances, manage pain more effectively and promote overall patient well-being in critical care settings. TRIAL REGISTRATION: NCT07100002.