Digital Stimulation and Anxiety and Sleep Quality in Intensive Care Unit Patients

The aim of this study is to examine the effect of digital visual and auditory stimulation on anxiety and sleep quality in patients hospitalized in the intensive care unit (ICU).

The questions to be answered within the scope of the research are:

Does the application of digital visual and auditory stimulation to patients in intensive care units have a significant effect on anxiety levels? Does the application of digital visual and auditory stimulation to patients in intensive care units have a significant effect on sleep quality? Does the application of digital visual and auditory stimulation to patients in intensive care units have a combined effect on anxiety levels and sleep quality?

Participants will:

The patients will be divided into two groups: an intervention group and a control group. The intervention group will receive visual and auditory stimuli once a day, every morning for three days. Sleep quality and anxiety levels will be measured after the digital visual and auditory stimuli.

The control group will continue with routine intensive care unit follow-up treatments.

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Key information

Conditions

ICU Patients

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Patients in the intervention group will be administered a questionnaire, the Richards-Campbell Sleep Scale, and the Hospital Anxiety and Depression Scale as pre-tests. Following this, for three consecutive days, the research nurse will show the patient nature images (landscapes, lakes, mountains, etc.) via tablet for approximately 20-30 minutes once a day in the mornings when the patient is available. While watching the images, Johann Sebastian Bach's instrumental classical music pieces (60-80 bpm) will be played through headphones. The pieces to be used as digital visual and auditory stimuli will be selected by the art therapy specialist in the study. During the intervention, patients' vital signs and clinical condition will be closely monitored, and the intervention will be terminated if any discomfort, hemodynamic instability, or intolerance to the procedure develops. The digital visual and auditory stimulus application will continue under the same conditions for three days, and at the end of the third day, the Richards-Campbell Sleep Scale and the Hospital Anxiety and Depression Scale will be administered again as post-tests. Control Group Patients in the control group will also be administered the Demographic Information Form, the Richards-Campbell Sleep Scale (RCSQ), and the Hospital Anxiety and Depression Scale (HADS) at the beginning of the data collection process, at the same time as the intervention group. Patients in the control group will not undergo any intervention during the study period, and their routine intensive care treatment and care will continue. At the end of the third day, the Richards-Campbell Sleep Scale and the Hospital Anxiety and Depression Scale will be administered again as a final test, simultaneously with the intervention group.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

18 years and above
Conscious [Glasgow Coma Scale(GCS)] ≥ 14)
Not connected to mechanical ventilation or receiving non-invasive support
Hearing and visual functions are sufficient
No communication problems
Able to answer questions correctly
Not under sedation
Expected to stay in the ICU for at least 48 hours

Exclusion criteria

Having a hearing or visual impairment
Being under sedation
Having impaired consciousness
Refusing to participate in the study

Treatment and study plan

Digital Visual and Auditory Stimulation

Other

Visually, they will be shown landscape images on a tablet. Simultaneously, they will listen to classical music (60-80 bpm) through headphones.

Primary outcomes

Richards-Campbell Sleep Questionnaire (RCSQ)

Time frame: The sleep questionnaire will be administered upon admission to the intensive care unit on the first day of the study and at the end of the third day of the intervention.

The Richard-Campbell Sleep Scale (RCSS) is a scale developed by Richards in 1987 to assess the quality of nocturnal sleep in patients. Adapted into Turkish by Özlü and Özer, and subsequently validated and its reliability studied, the scale consists of six items that evaluate the depth of nocturnal sleep, time to fall asleep, frequency of awakenings, duration of wakefulness, quality of sleep, and ambient noise level. Each item is evaluated on a visual analog scale ranging from 0 to 100. A score of "0-25" indicates very poor sleep, while a score of "76-100" indicates very good sleep. As the scale score increases, the patients' sleep quality also improves. The Cronbach's α value of the scale was determined to be 0.82.
Hospital Anxiety and Depression Scale (HADS)

Time frame: The scale will be administered as a first test during the initial interview at the beginning of the study and as a final test during the final interview at the end of the third day.

Developed by Zigmond and Snaith (1983) to determine a patient's risk of anxiety and depression, and to measure their level and severity, the scale's validity and reliability in Turkish were established by Aydemir et al. (1997). The scale contains 14 questions in total, with odd numbers measuring anxiety and even numbers measuring depression. The scale consists of two subscales: Anxiety (HAD-A) and Depression (HAD-D). In the validity and reliability study, the cutoff score for HAD-A was found to be 10/11, and for HAD-D, 7/8. Accordingly, scores above these points are considered at risk. The scale is a four-point Likert type, with a total score ranging from 0 to 42.

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Sponsors and collaborators

Lead sponsor

Cumhuriyet University

Other

Registry information

Official study title

The Effect of Digital Visual and Auditory Stimulation on Anxiety and Sleep Quality in Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Trial

Important dates

Study start: 2026
Primary completion: 2027
Study completion: 2027
First posted: Sep 15, 2026
Registry last updated: Sep 15, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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