# sleep: Evidence Review
Canonical: https://www.migaku.app/guides/sleep-guide
Category: ai-evidence-guide
Last reviewed: 2026-05-26
## Quick Answer
Progressive relaxation exercises improve sleep quality in individuals with type 2 diabetes, while sleep disturbances in intensive care units (ICUs) are linked to frequent clinical interactions. Nursing pillows pose a risk for sudden unexpected infant deaths in sleep environments.

## Key Takeaways
- Progressive relaxation exercises significantly enhance sleep quality in type 2 diabetes patients, as indicated by a randomized controlled study with 63 participants.
- ICU patients experience poor sleep quality, with a median nocturnal sleep duration of 5.6 hours and frequent awakenings, largely due to clinical interactions.
- Nursing pillows in infant sleep environments are associated with sudden unexpected infant deaths.

## Clinical Evidence Deep-Dive
A randomized controlled study involving 63 participants with type 2 diabetes demonstrated that progressive relaxation exercises significantly improved sleep quality. The Pittsburgh Sleep Quality Index scores were used to evaluate outcomes, showing marked improvement in the experimental group compared to controls.

In ICU settings, a secondary data analysis involving 37 patients revealed poor sleep quality, with a mean Richards-Campbell Sleep Questionnaire (RCSQ) score below 50 mm. Actigraphy data showed a median sleep duration of 5.6 hours and 33.4 awakenings per hour. Frequent clinical interactions, averaging nine per hour, were identified as a primary factor affecting sleep.

A report on sudden unexpected infant deaths highlighted the risk associated with nursing pillows in sleep environments, underscoring the need for caution in their use.

## Practical Protocol
- Implement progressive relaxation exercises in patients with type 2 diabetes to enhance sleep quality. Monitor improvements using the Pittsburgh Sleep Quality Index.
- Minimize unnecessary clinical interactions in ICUs to improve patient sleep quality. Consider adjusting care protocols to reduce nighttime disturbances.
- Avoid the use of nursing pillows in infant sleep environments to mitigate the risk of sudden unexpected infant deaths.

## FAQ
**What are progressive relaxation exercises?**
These exercises involve systematically tensing and relaxing muscle groups to achieve relaxation, which can improve sleep quality and reduce fatigue.

**How do clinical interactions affect sleep in ICUs?**
Frequent clinical interactions disrupt sleep, leading to increased awakenings and reduced sleep duration.

**Are nursing pillows safe for infants?**
Nursing pillows pose a risk for sudden unexpected infant deaths when used in sleep environments.

## References
1. Vardar Inkaya B. (2026). The Effect of Progressive Relaxation Exercises Applied to Individuals With Type 2 Diabetes on FATIQUE Level and Sleep Quality: A Randomised Controlled Study. [PMC13053216](https://pmc.ncbi.nlm.nih.gov/articles/PMC13053216/)
2. Islam A. (2026). Clinical Care Interaction and Patient Sleep in the Intensive Care Unit: A Secondary Data Analysis. [PMC13071779](https://pmc.ncbi.nlm.nih.gov/articles/PMC13071779/)
3. Deputy Director for Public Health Science and Surveillance. (2025). Nursing Pillows in the Sleep Environment and Sudden Unexpected Infant Deaths — Georgia, January 2013–December 2022. [CDC](https://www.cdc.gov/mmwr/volumes/74/wr/mm7419a2.htm)