In spite of randomization, there were significant differences between the experimental group and the control group. The GI group had a greater percentage of women, much more ethnic diversity, more on-pump procedures (valves, CABG), longer procedures, and less use of beta blockers than the control group. They were also older. (On-pump surgeries are associated with greater sleep difficulty and more inflammation.)
The investigators found a high compliance rate (85% at T-1, 100% at T-2 and T-3, and high satisfaction with the guided imagery as a way of promoting sleep.
There were distinct trends (but short of significance) in the GI group for steadier improvement in sleep onset and sleep activity over the TAU controls. Similarly, there was a trend toward a more consistent decline in cortisol and C-RP levels in the GI group over the controls.
The researchers posit that the daunting conditions in the ICU environment are so antagonistic to sound sleep, that guided imagery is not enough to alone replace sleep medication, but adds value when used adjunctively.. They also call for a larger study to equalize the dramatic differences in the characteristics of subjects in the two conditions.
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