{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:13:32Z","timestamp":1787649212738,"version":"build-2736575974"},"reference-count":73,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002850","name":"Fondo Nacional de Desarrollo Cient\u00edfico y Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["1201772"],"award-info":[{"award-number":["1201772"]}],"id":[{"id":"10.13039\/501100002850","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>In critically ill patients, sleep and circadian rhythms are greatly altered. These disturbances have been associated with adverse consequences, including increased mortality. Factors associated with the ICU environment, such as exposure to inadequate light and noise levels during the day and night or inflexible schedules of daily care activities, have been described as playing an essential role in sleep disturbances. The main objective of this study is to evaluate the impact of the use of a multifaceted environmental control intervention in the ICU on the quantity and quality of sleep, delirium, and post-intensive care neuropsychological impairment in critically ill patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a prospective, parallel-group, randomized trial in 56 critically ill patients once they are starting to recover from their acute illness. Patients will be randomized to receive a multifaceted intervention of environmental control in the ICU (dynamic light therapy, auditory masking, and rationalization of ICU nocturnal patient care activities) or standard care. The protocol will be applied from enrollment until ICU discharge. Baseline parameters, light and noise levels, polysomnography and actigraphy, daily oscillation of plasma concentrations of Melatonin and Cortisol, and questionnaires for the qualitative evaluation of sleep, will be assessed during the study. In addition, all patients will undergo standardized follow-up before hospital discharge and at 6 months to evaluate neuropsychological impairment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>This study is the first randomized clinical trial in critically ill patients to evaluate the effect of a multicomponent, non-pharmacological environmental control intervention on sleep improvement in ICU patients. The results will provide data about the potential synergistic effects of a combined multi-component environmental intervention in ICU on outcomes in the ICU and long term, and the mechanism of action.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>ClinicalTrials.gov, NCT. Registered on January 10, 2023. Last updated on 24 Jan 2023.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0286180","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T17:38:25Z","timestamp":1685036305000},"page":"e0286180","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Improve sleep in critically ill patients: Study protocol for a randomized controlled trial for a multi-component intervention of environment control in the ICU"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0930-4452","authenticated-orcid":true,"given":"Leyla","family":"Alegria","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Brockmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Repetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0578-628X","authenticated-orcid":true,"given":"Douglas","family":"Leonard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5902-1170","authenticated-orcid":true,"given":"Rodrigo","family":"Cadiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Paredes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idalid","family":"Rojas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Moya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Oviedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricio","family":"Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Bakker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"pone.0286180.ref001","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ccc.2008.02.002","article-title":"Gamaldo Ch: Normal sleep and circadian processes","volume":"24","author":"N Collop","year":"2008","journal-title":"Crit Care Clin"},{"key":"pone.0286180.ref002","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.cden.2012.01.005","article-title":"Basic biology of sleep","volume":"56","author":"J Harrington","year":"2012","journal-title":"Dent Clin N Am"},{"key":"pone.0286180.ref003","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s13054-019-2366-0","article-title":"Sleep and circadian rhythm in critical care.","volume":"23","author":"I Telias","year":"2019","journal-title":"Crit carer."},{"key":"pone.0286180.ref004","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1378\/chest.08-1546","article-title":"Sleep in the ICU","volume":"136","author":"K. Hardin","year":"2009","journal-title":"CHEST"},{"issue":"5","key":"pone.0286180.ref005","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.smrv.2007.11.004","article-title":"Sleep in the intensive care unit.","volume":"12","author":"X Drouot","year":"2008","journal-title":"Sleep Med Rev."},{"issue":"7","key":"pone.0286180.ref006","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1164\/rccm.201411-2099CI","article-title":"Sleep in the intensive care unit","volume":"191","author":"M Pisani","year":"2015","journal-title":"Am J respir Crit Care Med"},{"issue":"1","key":"pone.0286180.ref007","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/0885066614538749","article-title":"Sleep in the intensive care unit: A review.","volume":"31","author":"L Pulak","year":"2016","journal-title":"J Intensive care Med"},{"key":"pone.0286180.ref008","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13613-018-0408-4","article-title":"Association of intensive care unit delirium with sleep disturbance and functional disability after critical illness: an observational cohort study.","volume":"8","author":"M Altman","year":"2018","journal-title":"Ann Intensive Care"},{"issue":"6","key":"pone.0286180.ref009","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.iccn.2009.07.002","article-title":"Factors that impact on sleep in intensive care patients.","volume":"25","author":"A Tembo","year":"2009","journal-title":"Intensive Crit Care Nurs"},{"issue":"3","key":"pone.0286180.ref010","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.ccc.2008.02.006","article-title":"Adverse effects of sleep deprivation in the ICU.","volume":"24","author":"R Salas","year":"2008","journal-title":"Crit Care Clin."},{"key":"pone.0286180.ref011","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1046\/j.1365-2869.2000.00225.x","article-title":"Neural basis of alertness and cognitive performance impairments during sleepiness. Effects of 24 h of sleep deprivation on waking human regional brain activity","volume":"9","author":"M Thomas","year":"2000","journal-title":"J Sleep Res"},{"key":"pone.0286180.ref012","doi-asserted-by":"crossref","first-page":"204","DOI":"10.4037\/NCI.0b013e31822052cb","article-title":"Sleep disturbances and fatigue in critically ill patients.","volume":"22","author":"EE Matthews","year":"2011","journal-title":"AACN Adv Crit Care"},{"issue":"9","key":"pone.0286180.ref013","first-page":"1457","article-title":"Sleep disturbance after hospitalization and critical illness: A systematic review.","volume":"14","author":"M Altman","year":"2017","journal-title":"AnnalsATS."},{"key":"pone.0286180.ref014","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.rmed.2016.03.009","article-title":"Assessment of sleep quality post-hospital discharge in survivors of critical illness.","volume":"114","author":"K Solverson","year":"2016","journal-title":"Respir Med."},{"key":"pone.0286180.ref015","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1007\/s00134-009-1396-5","article-title":"Depression in general intensive care unit survivors: a systematic review.","volume":"35","author":"DS Davydow","year":"2009","journal-title":"Intensive Care Med"},{"key":"pone.0286180.ref016","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.sleep.2007.03.005","article-title":"Neurobiology of REM and NREM sleep.","volume":"8","author":"RW McCarley","year":"2007","journal-title":"Sleep Med."},{"issue":"2","key":"pone.0286180.ref017","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1177\/0885066610394322","article-title":"Sleep deprivation in critical illness: Its role in physical and psychological recovery.","volume":"27","author":"B Kamdar","year":"2012","journal-title":"J Intensive Care Med"},{"issue":"3","key":"pone.0286180.ref018","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.ccc.2008.03.002","article-title":"Sleep and Mechanical Ventilation.","volume":"24","author":"A Ozsancak","year":"2008","journal-title":"Crit Care Clin"},{"key":"pone.0286180.ref019","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jcrc.2016.09.005","article-title":"Sleep in intensive care unit: The role of environment.","volume":"37","author":"Y Boyko","year":"2017","journal-title":"J Crit Care."},{"key":"pone.0286180.ref020","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.smrv.2015.08.009","article-title":"The effects of light therapy on sleep problems: A systematic review and meta-analysis.","volume":"29","author":"A Van Maanen","year":"2016","journal-title":"Sleep Med Rev"},{"issue":"8","key":"pone.0286180.ref021","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1513\/AnnalsATS.201601-087OC","article-title":"Sleep in the ICU (SLEEPii) Task Force. Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers.","volume":"13","author":"BB Kamdar","year":"2016","journal-title":"Ann Am Thorac Soc."},{"issue":"4","key":"pone.0286180.ref022","first-page":"406","article-title":"A patient survey of sleep quality in the Intensive Care Unit.","volume":"78","author":"A Little","year":"2012","journal-title":"Minerva Anaestesiol"},{"issue":"4","key":"pone.0286180.ref023","doi-asserted-by":"crossref","first-page":"278","DOI":"10.4037\/ajcc2017333","article-title":"Factors Influencing Patients\u2019 Sleep in the Intensive Care Unit: Perceptions of Patients and Clinical Staff.","volume":"26","author":"Q Ding","year":"2017","journal-title":"Am J Crit Care."},{"issue":"2","key":"pone.0286180.ref024","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.enfie.2018.01.002","article-title":"Patients\u2019 perceptions of sleep in a Critical Care Unit.","volume":"29","author":"L Carrera-Hern\u00e1ndez","year":"2018","journal-title":"Enferm Intensiva"},{"issue":"2","key":"pone.0286180.ref025","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/cc7154","article-title":"Clinical review: The impact of noise on patients\u2019 sleep and the effectiveness of noise reduction strategies in intensive care units.","volume":"13","author":"H Xie","year":"2009","journal-title":"Crit Care"},{"key":"pone.0286180.ref026","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1186\/cc1021","article-title":"Alarms in the intensive care unit: how can the number of false alarms be reduced.","volume":"5","author":"MC Chambrin","year":"2001","journal-title":"Crit Care."},{"key":"pone.0286180.ref027","doi-asserted-by":"crossref","first-page":"3629","DOI":"10.1121\/1.2118327","article-title":"Noise levels in Johns Hopkins Hospital","volume":"118","author":"IJ Busch-Vishniac","year":"2005","journal-title":"J Acoust Soc Am"},{"issue":"2","key":"pone.0286180.ref028","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1891\/0730-0832.29.2.87","article-title":"Variations of NICU sound by location and time of day.","volume":"29","author":"SA Matook","year":"2010","journal-title":"Neonatal Netw: J Neonatal Nurs."},{"issue":"5","key":"pone.0286180.ref029","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.jcrc.2011.09.003","article-title":"Noise in hospital intensive care units-a critical review of a critical topic.","volume":"27","author":"A Konkani","year":"2012","journal-title":"J Crit Care"},{"issue":"3\u20134","key":"pone.0286180.ref030","first-page":"396","article-title":"Efficacy of controlling night-time noise and activities to improve patients\u2019 sleep quality in a surgical intensive care unit.","volume":"20","author":"SY Li","year":"2011","journal-title":"J Clin Nurs"},{"issue":"1","key":"pone.0286180.ref031","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1136\/adc.65.1.135","article-title":"White noise and sleep induction","volume":"65","author":"JA Spencer","year":"1990","journal-title":"Arch Dis Child"},{"issue":"4","key":"pone.0286180.ref032","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1542\/peds.2013-3617","article-title":"Infant sleep machines and hazardous sound pressure levels","volume":"133","author":"SC Hugh","year":"2014","journal-title":"Pediatrics"},{"issue":"3","key":"pone.0286180.ref033","doi-asserted-by":"crossref","DOI":"10.1088\/1741-2552\/abe399","article-title":"Characterizing pink and white noise in the human electroencephalogram","volume":"18","author":"RJ Barry","year":"2021","journal-title":"J Neural Eng"},{"key":"pone.0286180.ref034","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jtbi.2012.04.006","article-title":"Pink noise: effect on complexity synchronization of brain activity and sleep consolidation","volume":"306","author":"J Zhou","year":"2012","journal-title":"Journal of theoretical biology"},{"key":"pone.0286180.ref035","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/978-981-13-6123-4_7","article-title":"Advances in Understanding, Diagnosis, and Treatment of Tinnitus","volume":"1130","author":"D Tang","year":"2019","journal-title":"Adv Exp Med Biol"},{"issue":"2","key":"pone.0286180.ref036","doi-asserted-by":"crossref","first-page":"139","DOI":"10.5935\/0946-5448.20170026","article-title":"Effects of Tinnitus Retraining Therapy with Different Colors of Sound.","volume":"21","author":"S Barozzi","year":"2017","journal-title":"Int Tinnitus J."},{"issue":"2","key":"pone.0286180.ref037","doi-asserted-by":"crossref","first-page":"102","DOI":"10.4037\/ajcc2004.13.2.102","article-title":"Nocturnal care interactions with patients in critical care units.","volume":"13","author":"LM Tamburri","year":"2004","journal-title":"Am J Crit care"},{"issue":"1","key":"pone.0286180.ref038","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.1365-2702.2004.01010.x","article-title":"Sleep disturbance: the patient care activities applied at the night shift in the intensive care unit.","volume":"14","author":"S Celik","year":"2005","journal-title":"J Clin Nurse"},{"issue":"3","key":"pone.0286180.ref039","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/DCC.0000000000000177","article-title":"Nursing Interactions With Intensive Care Unit Patients Affected by Sleep Deprivation: An Observational Study.","volume":"35","author":"GD Giusti","year":"2016","journal-title":"Dimens Crit Care Nurs."},{"issue":"6","key":"pone.0286180.ref040","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1111\/anae.12686","article-title":"Bundling sleep promotion with delirium prevention: ready for prime time?","volume":"69","author":"BB Kamdar","year":"2014","journal-title":"Anaesthesia"},{"issue":"1","key":"pone.0286180.ref041","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1093\/bja\/aet304","article-title":"Earplugs and eye masks vs routine care prevent sleep impairment in post-anesthesia care unit: a randomized study","volume":"112","author":"M Le Guen","year":"2014","journal-title":"Br J Anaesth"},{"issue":"4","key":"pone.0286180.ref042","doi-asserted-by":"crossref","first-page":"357","DOI":"10.4037\/ajcc2013545","article-title":"Do earplugs and eye masks affect sleep and delirium outcomes in the critically ill?","volume":"22","author":"A Alway","year":"2013","journal-title":"Am J Crit Care"},{"issue":"3","key":"pone.0286180.ref043","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/S2213-2600(16)00025-4","article-title":"Dynamic light application therapy to reduce the incidence and duration of delirium in intensive-care patients: a randomized controlled trial","volume":"4","author":"KS Simons","year":"2016","journal-title":"Lancet Respir Med"},{"issue":"6","key":"pone.0286180.ref044","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.iccn.2015.07.001","article-title":"Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit.","volume":"31","author":"M Engwall","year":"2015","journal-title":"Intensive Crit Care Nurs"},{"issue":"2","key":"pone.0286180.ref045","doi-asserted-by":"crossref","first-page":"103","DOI":"10.15171\/jcs.2016.011","article-title":"Effect of White Noise on Sleep in Patients Admitted to a Coronary Care.","volume":"5","author":"P Farokhnezhad Afshar","year":"2016","journal-title":"J Caring Sci."},{"issue":"5","key":"pone.0286180.ref046","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.sleep.2004.12.004","article-title":"The influence of white noise on sleep in subjects exposed to ICU noise.","volume":"6","author":"ML Stanchina","year":"2005","journal-title":"Sleep Med"},{"issue":"3","key":"pone.0286180.ref047","first-page":"180","article-title":"Creating Naptime: An Overnight, Nonpharmacologic Intensive Care Unit Sleep Promotion Protocol.","volume":"5","author":"MP Knauert","journal-title":"J Patient Exp. 2108"},{"issue":"3","key":"pone.0286180.ref048","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/CCM.0b013e3182746442","article-title":"The effect of a quality improvement intervention on perceived sleep quality and cognition in a medical ICU.","volume":"41","author":"BB Kamdar","year":"2013","journal-title":"Crit Care Med"},{"issue":"3","key":"pone.0286180.ref049","doi-asserted-by":"crossref","first-page":"e12607","DOI":"10.1111\/jsr.12607","article-title":"Effect of the use of earplugs and eye mask on the quality of sleep in intensive care patients: a systematic review.","volume":"27","author":"H Locihov\u00e1","year":"2018","journal-title":"J Sleep Res."},{"issue":"2","key":"pone.0286180.ref050","doi-asserted-by":"crossref","first-page":"R66","DOI":"10.1186\/cc8965","article-title":"Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment.","volume":"14","author":"RF Hu","year":"2010","journal-title":"Crit Care."},{"issue":"10","key":"pone.0286180.ref051","first-page":"CD008808","article-title":"Non-pharmacological interventions for sleep promotion in the intensive care unit.","author":"RF Hu","year":"2015","journal-title":"Cochrane Database Syst Rev."},{"issue":"2","key":"pone.0286180.ref052","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1186\/cc10000","article-title":"The effect of light on critical illness.","volume":"15","author":"R Castro","year":"2011","journal-title":"Crit Care"},{"issue":"9","key":"pone.0286180.ref053","doi-asserted-by":"crossref","first-page":"R73","DOI":"10.1088\/0967-3334\/37\/9\/R73","article-title":"Exposure to light and darkness and its influence on physiological measures of intensive care unit patients-a systematic literature review.","volume":"37","author":"B Weiss","year":"2016","journal-title":"Physiol Meas."},{"issue":"1","key":"pone.0286180.ref054","first-page":"5","article-title":"Patient-centered lighting environments to improve health care in the intensive care unit.","volume":"6","author":"A Luetz","year":"2016","journal-title":"Clin Health Promot"},{"key":"pone.0286180.ref055","first-page":"152","author":"MBC Aries","year":"2005"},{"issue":"6565","key":"pone.0286180.ref056","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1038\/379540a0","article-title":"Dose-response relationships for resetting of human circadian clock by light","volume":"379","author":"DB Boivin","year":"1996","journal-title":"Nature"},{"issue":"2","key":"pone.0286180.ref057","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.ccc.2018.11.008","article-title":"Melatonin in Critical Care.","volume":"35","author":"A Marra","year":"2019","journal-title":"Crit Care Clin."},{"issue":"18","key":"pone.0286180.ref058","first-page":"302252","article-title":"Sleep deprivation determinants as perceived by intensive care unit patients: Findings from a systematic review, meta-summary and meta-synthesis.","volume":"S09643397","author":"E Mattiussi","year":"2019","journal-title":"Intensive Crit Care Nurs."},{"key":"pone.0286180.ref059","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/CCM.0000000000001282","article-title":"Circadian rhythm disruption in the critically ill: an opportunity for improving outcomes.","volume":"44","author":"MA Oldham","year":"2016","journal-title":"Crit Care Med"},{"issue":"3","key":"pone.0286180.ref060","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S2213-2600(16)00055-2","article-title":"Light therapy and chronobiology in critical illness","volume":"4","author":"D. Annanne","year":"2016","journal-title":"Lancet Respir Med"},{"issue":"4","key":"pone.0286180.ref061","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1592\/phco.21.5.431.34487","article-title":"Confirming the reliability of the sedation-agitation scale administered by ICU nurses without experience in its use.","volume":"21","author":"KM Brandl","year":"2001","journal-title":"Pharmacotherapy"},{"issue":"1","key":"pone.0286180.ref062","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1186\/s13054-018-2182-y","article-title":"Noise in the intensive care unit and its influence on sleep quality: a multicenter observational study in Dutch intensive care units.","volume":"22","author":"KS Simons","year":"2018","journal-title":"Crit Care."},{"key":"pone.0286180.ref063","article-title":"Mapping sources of noise in an intensive care unit.","author":"JL Darbyshire","year":"2019","journal-title":"Anesthesia"},{"key":"pone.0286180.ref064","doi-asserted-by":"crossref","first-page":"597","DOI":"10.5664\/jcsm.2172","article-title":"Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine","volume":"8","author":"RB Berry","year":"2012","journal-title":"J Clin Sleep Med."},{"issue":"6","key":"pone.0286180.ref065","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1186\/s13054-014-0628-4","article-title":"Sleep continuity: a new metric to quantify disrupted hypnograms in non-sedated intensive care unit patients.","volume":"18","author":"X Drouot","year":"2014","journal-title":"Crit Care"},{"issue":"4","key":"pone.0286180.ref066","doi-asserted-by":"crossref","first-page":"329","DOI":"10.4037\/ajcc2017660","article-title":"Feasibility of Continuous Actigraphy in Patients in a Medical Intensive Care Unit.","volume":"26","author":"BB Kamdar","year":"2017","journal-title":"Am J Crit Care."},{"issue":"9","key":"pone.0286180.ref067","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1513\/AnnalsATS.201801-004OC","article-title":"Actigraphy to Evaluate Sleep in the Intensive Care Unit. A Systematic Review","volume":"15","author":"KE Schwab","year":"2018","journal-title":"Ann Am Thorac Soc"},{"issue":"2","key":"pone.0286180.ref068","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1891\/1061-3749.8.2.131","article-title":"Measurement of sleep in critically ill patients.","volume":"8","author":"KC Richards","year":"2000","journal-title":"J Nurs Meas."},{"key":"pone.0286180.ref069","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburg Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice.","volume":"28","author":"DJ Buyese","year":"1989","journal-title":"Psychiatric Research."},{"issue":"1","key":"pone.0286180.ref070","first-page":"4","article-title":"Confusion Assessment Method for diagnosing delirium in ICU patients (CAM-ICU): cultural adaptation and validation of the Spanish version.","volume":"34","author":"E Tobar","year":"2010","journal-title":"Med Intensiva."},{"issue":"4","key":"pone.0286180.ref071","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0163-8343(03)00043-4","article-title":"A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population.","volume":"25","author":"MJ Herrero","year":"2003","journal-title":"Gen Hosp Psychiatry"},{"issue":"4","key":"pone.0286180.ref072","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.","volume":"53","author":"S Charbonneau","year":"2005","journal-title":"J Am Geriatr Soc.Apr"},{"issue":"1","key":"pone.0286180.ref073","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1186\/s13054-017-1865-0","article-title":"Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study.","volume":"21","author":"A Demoule","year":"2017","journal-title":"Crit Care."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0286180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T17:39:24Z","timestamp":1685036364000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0286180"}},"subtitle":[],"editor":[{"given":"Luis Felipe","family":"Reyes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,5,25]]},"references-count":73,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0286180","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,25]]}}}