Introduction Sleep disruption is common in intensive care units (ICUs) and is associated with adverse outcomes. We evaluated whether a multidisciplinary sleep protocol improves subjective sleep quality in critically ill patients. Methods This multicenter quasi-experimental before–after study (2022–2024) was conducted in two Brazilian ICUs. Adult patients with an ICU stay of ≥2 nights were included. Sleep was assessed using the Richards–Campbell Sleep Questionnaire (RCSQ) and the Sleep in the ICU Questionnaire (SICUQ). Following baseline assessment, structured training and a multifaceted “ABCDEF of Sleep” protocol were implemented. The primary outcome was the global RCSQ score; secondary outcomes included SICUQ domains and clinical outcomes. Results A total of 112 patients were included (control = 61; intervention = 51). The primary outcome (aggregated 3-night RCSQ score) did not differ between groups ( p = 0.31). In per-night analyses, RCSQ scores were higher on the second night in the intervention group ( p = 0.008), with no differences on nights 1 or 3. The intervention improved perceived sleep quality and reduced environmental disturbances ( p ≤ 0.001), without effects on mortality, mechanical ventilation, or length of stay. Family-reported sleep perception did not differ between groups. Conclusions A pragmatic sleep protocol improved subjective sleep quality and reduced environmental disturbances in ICU patients, but did not impact major clinical outcomes. Larger studies using objective measures are needed.
Drehmer et al. (2026) studied this question.