Uncorrected Proof Med Surg Nurs J. 2019 August; 8(3):e98762. Published online 2019 October 23. doi: 10.5812/msnj.98762. Research Article Effect of Eye Masks, Earplugs, and Quiet Time Protocol on Sleep Quality of Patients Admitted to the Cardiac Care Unit: A Clinical Trial Study Ebrahim Ebrahimi Tabas 1 , Fatemeh Khodadadi 2 , Hamed Sarani 1 , Farshid Saeedinezhad 1 and Mozhgan Jahantigh 1, 2, * 1 Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran 2 Department of Nursing, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran * Corresponding author: M.Sc., Department of Nursing, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran. Email: jahanmed@gmail.com Received 2019 October 09; Accepted 2019 October 09. Abstract Background: There are several factors such as noise and light, which affect the sleep quality of patients admitted to the cardiac care unit (CCU) and cause sleep disorders in these individuals. Objectives: The purpose of this study was to compare the impact of applying eye masks and earplugs as well as implementing the quiet time (QT) protocol on the sleep quality of patients hospitalized in the CCU of Ali Ibn Abi Talib Hospital in Zahedan. Methods: This clinical trial was performed on 135 CCU patients. Subjects meeting the inclusion criteria were chosen through conve- nience sampling. The patients were divided into three groups (control, eye mask and earplugs, and QT protocol) and were matched in terms of background variables. The subjects were studied over three days after admission. On the first night, the patients’ sleep quality was determined by the Verran and Snyder-Halpern Sleep Scale (VSH), and on the second and third nights, the interventions (eye mask and earplugs and QT protocol) were administered. The next day, as the post-test, patients’ sleep quality was measured again. ANOVA test was used to determine and compare the mean sleep quality of the three groups, and the chi-square test was employed to compare the qualitative variables in the three groups. Results: After the intervention, the mean score of sleep disturbance was significantly different between the control and the two experimental groups. Also, the mean score of sleep efficacy was higher in the eye mask and earplugs group than the other two groups, indicating a better sleep quality in this group. Conclusions: As low-cost devices with no side effects, eye masks and earplugs can improve the quality of sleep in [CCU] patients, and nurses could utilize them to help reduce environmental factors, which disturb patients’ sleep. Keywords: Sleep Disturbance, Sleep Efficacy, CCU, Eye Mask, Earplugs, Quiet Time Protocol 1. Background Cardiovascular diseases are chronic conditions that not only have a high mortality rate, but in the long run, due to their debilitating nature, cause some limitations in one’s life. According to the World Health Organization, coronary artery disease accounted for 30% of deaths by 2013, and it remains the leading cause of post-cancer mor- tality by 2020 (1). Patients with acute heart problems such as stroke or coronary heart disease are hospitalized in the CCU to re- ceive special care. The basis of care in the CCU is to provide special conditions for the patient to have a complete rest and to reduce their cardiac activity. Despite defining such a task for the CCU, patients’ who sleep in this unit may be impaired for a variety of reasons, one of which concerns environmental factors (2). Sleep is a complex and dynamic physiological state, which is vital for survival. Sleep de- privation and disruption can lead to heightened sensitiv- ity to pain, increased sympathetic activity and decreased parasympathetic activity of the heart, immune system dys- function, alterations in endocrine and metabolic systems, increased heart rate, hypoxia, cardiac dysrhythmia, and hemodynamic instability (3). Sleep disturbance in CCU patients depends on several factors, which could result in acute coronary syndrome and aggravate patient’s status. In this regard, the physi- cal environment of the patient is of particular importance. Noise and light are among the most common factors that interfere with patient’s sleep schedule and are quite recur- Copyright © 2019, Medical - Surgical Nursing Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.