Sleep disturbances are common in the ICU and are associated with worse outcomes like delirium, anxiety, pain, prolonged weaning, increased length of stay, and mortality. Although several factors like disease-related, procedure-related and environment-   related have been associated with sleep disturbances in ICU patients; no recommendation has yet been made on improving sleep and restoring circadian rhythm. Studies have evaluated the effect of non-pharmacological and pharmacological interventions in the ICU and they suggest that certain modifications may improve sleep in critically ill patients. However, these studies have been conducted in specialized ICU settings and in western populations, evaluating only isolated interventions and or multifaceted interventions. Further, it is still being inconclusive whether these proposed benefits can be replicated in a randomized controlled trial or would translate to Indian settings.

The current study will evaluate the impact in the quality of sleep with non-pharmacological measures along with or without pharmacological measures (melatonin) in critically ill patients and if there is any significant improvement in sleep outcomes with both the measures or either of the measures, this can help in framing a protocol for improving the quality of sleep in critically ill adult patients as well as decreasing the incidence of delirium, length of stay, pain, anxiety, weaning difficulties and mortality.