Sleep disturbance and circadian disruption are common in advanced illness, where pain, dyspnoea, psychological distress, treatment effects, medication exposure, reduced daytime activity, environmental disturbance, and night-time clinical care can interact. Nonpharmacological approaches may be attractive in palliative settings because they can complement symptom management without automatically adding medication burden, yet evidence spans heterogeneous interventions and rarely examines how nursing work and night-time care organization shape implementation. To map empirical evidence on nonpharmacological approaches relevant to sleep and circadian disturbance in adults with advanced illness and to examine how timing, feasibility, patient preference, environmental conditions, and organization of palliative nursing care affect interpretation and translation. Empirical studies published from 2017 through 2024 were eligible when they examined adults with advanced, incurable, or metastatic cancer or comparable advanced serious illness in palliative, hospice, supportive, or end-of-life contexts; or palliative-care personnel when the study directly addressed organization or implementation of sleep-promoting care. Eligible concepts included behavioral, environmental, light-based, exercise or mind-body, biofeedback, massage, mindfulness, and directly sleep-related nursing or service practices. A reproducibility search was conducted across scholarly bibliographic and supplementary citation routes using combinations of advanced illness, palliative care, sleep, insomnia, circadian disturbance, nonpharmacological intervention, and night-time nursing terms. Eligibility was restricted to the prespecified 2017–2024 publication window. Study design, population, setting, intervention or organizational exposure, sleep-related measurement, clinical timing, principal findings, feasibility, contrary or null findings, and applicability limitations were charted. Evidence was mapped descriptively rather than pooled for comparative effectiveness. Fifty records were captured before deduplication. After removal of 8 duplicates and 9 records outside the publication window, 33 records underwent title/abstract screening. Thirteen were excluded, 20 full texts were assessed, and 6 were excluded at full-text review, leaving 14 empirical evidence units. Eleven examined patient-level nonpharmacological interventions and three examined nursing or service-organization issues. The evidence covered exercise and mind-body approaches, cognitive-behavioral and behavioral-environmental strategies, electrical or biofeedback interventions, light-related approaches, massage, and staff-level sleep-support practices. Designs, populations, outcome measures, intervention duration, and feasibility conditions were markedly heterogeneous. Nonpharmacological sleep care in advanced illness is better characterized as a context-sensitive portfolio than as a single therapeutic pathway. Evidence supports continued evaluation of selected behavioral, physical, light-related, and integrative approaches, while the organizational conditions under which sleep is protected at night remain comparatively under-studied. Integrative palliative nursing therefore requires simultaneous attention to patient-defined priorities, treatment burden, symptom instability, timing, environment, and care-delivery routines.
