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When recovering in a hospital, it’s not only medicines, staff and advanced technologies that help patients recover. Getting enough sleep is also important. But sometimes a hospital environment can be too noisy for restful sleep.
A study by Orfeu Buxton, PhD, of the BWH Division of Sleep Medicine, found that certain noises in a common hospital setting can disrupt sleep, which may negatively affect brain activity and heart function. The study was conducted in collaboration with Jeffrey Ellenbogen, MD, director of Sleep Medicine at Massachusetts General Hospital, and Jo Solet, PhD, Cambridge Health Alliance. “Hospitals, and actually most urban sleep environments, are increasingly noise-polluted,” said Buxton. “This study highlights the importance of sleep for restoration and healing that is particularly important for hospitalized patients.”
Sleep Study
Researchers recruited 12 healthy volunteers to participate in the three-day study, which took place in a carefully controlled setting—a sleep laboratory. On the first night, the participants slept without any disruption. On the following two nights, they were presented with sounds commonly heard in a hospital, including a telephone, ice machine, voices in the hall, outside traffic and an intravenous pump alarm.
As expected, louder sounds were more likely to disrupt sleep.
However, there were unexpectedly large differences in sleep disruption based on sound type—regardless of volume. The researchers found that of all sound types, electronic sounds (intravenous pump alarms and phones) were most disruptive, even at a volume just above a whisper. Following electronic sounds, voices were found to be most disruptive.
Sleep disruption caused by hospital noises also temporarily increased heart rate. According to the researchers, elevated heart rates due to repeated sleep disruptions could jeopardize the health of the most vulnerable patients.
Steps toward Peace and Quiet
Researchers believe that to provide the highest quality of patient care, improving the acoustic environments of new and existing health care facilities needs to be considered.
Some improvement strategies range from implementing acoustic performance guidelines when designing patient care facilities to altering night-care routines.
BWH has already taken steps to create quieter spaces for its patients. According to Michael Fraai, BWH Biomedical Engineering director, the Carl J. and Ruth Shapiro Cardiovascular Center has many features to reduce noise pollution. One example is monitoring alarm sound levels, so that the alarms are heard by clinicians but are not too loud for patients.
“We have a standard alarm noise level for all patient care monitors in Shapiro and the Tower,” said Fraai. “Because we have more monitors in Shapiro, we trialed several lower settings to arrive at a lower alarm volume that was still safe.”