Restoring Rest to ICU Patients

Sleep has long been recognized as one of the body’s most important tools for healing. Yet in intensive care units, where critically ill patients require around-the-clock monitoring and treatment, restorative rest can be elusive.

For Baylor’s Louise Herrington School of Nursing researcher Nicole Gorecki, DNP, APRN, AGACNP-BC, CCRN, understanding how hospitals can better support sleep in these settings has become an important focus. Gorecki is leading Baylor University Medical Center’s participation in a national study comparing approaches to improve sleep and reduce delirium among critically ill adults.

“This study represents an important opportunity to improve the experience and recovery of critically ill patients,” Gorecki said. “In the ICU, sleep is often overlooked, yet it plays a critical role in healing and recovery.”

These fundamental questions are bringing together some of the nation’s leading healthcare institutions in a study funded by the Patient-Centered Outcomes Research Institute (PCORI). Led at the University of California San Diego, the project includes Baylor University Medical Center, University of California San Diego, University of California San Francisco, Vanderbilt University Medical Center, University of Utah, AdventHealth Orlando, Massachusetts General Hospital and the University of Puerto Rico. Together, the participating sites represent 16 intensive care units serving diverse patient populations across the country. While healthcare providers broadly recognize the importance of sleep in the healing process, hospitals vary widely in how they promote and protect it, and researchers still have limited evidence about which approaches are most effective and sustainable.

The study compares two structured ICU care bundles. One focuses on non-medication strategies such as reducing nighttime noise and light, minimizing unnecessary sleep interruptions and encouraging daytime wakefulness. The second combines those environmental interventions with carefully targeted medication management, including medication reviews and the selective use of sleep-promoting therapies when appropriate. By comparing the two approaches in real-world clinical settings, researchers hope to answer a practical question: is optimizing the ICU environment enough to improve sleep and recovery, or do certain medication strategies offer additional benefits? 

Through evidence gathered from patients, caregivers and healthcare providers, researchers hope to identify strategies that can be implemented across a wide range of hospitals to help patients recover better through healthy, restorative sleep.