Advertisement

Can ICUs create more sleep by creating less noise?

  • Biren B. Kamdar
  • Koen S. Simons
  • Peter E. SpronkEmail author
Less is more in Intensive Care

“True silence is the rest of the mind,

and is to the spirit

what sleep is to the body,

nourishment and refreshment.”

William Penn

In 1974 and 1999, respectively, the US Environmental Protection Agency (EPA) and World Health Organization (WHO) published landmark guidelines for public noise [ 1], mandating that daytime and nighttime hospital noise, defined as “unwanted sound”, average less than 35–45 and 30–35 decibels (dB, i.e., a typical library), respectively, and nighttime peaks not exceed 40–45 dB (i.e., a normal conversation and threshold to maintain sleep). More recently the European community published an updated directive as well [ 2]. Compliance with these guidelines is poor, particularly in ICUs as alarming machines, staff conversations, bedside visitors, and routine activities such as supply restocking and floor waxing routinely push noise levels above 80 dB (i.e., a garbage disposal) [ 1]. Sound intensity in ICUs has increased over time, doubling (4 dB on logarithmic scale)...

Notes

Compliance with ethical standards

Conflicts of interest

All authors report no conflicts of interest.

References

  1. 1.
    Kamdar BB, Martin JL, Needham DM (2017) Noise and light pollution in the hospital: a call for action. J Hosp Med 12:861–862CrossRefGoogle Scholar
  2. 2.
    Commission E (2002) Directive 2002/49/EC of the European Parliament and of the Council of 25 June 2002 relating to the assessment and management of environmental noise. Off J Eur Communities 189:12–25Google Scholar
  3. 3.
    Jaiswal SJ, Garcia S, Owens RL (2017) Sound and light levels are similarly disruptive in ICU and non-ICU wards. J Hosp Med 12:798–804CrossRefGoogle Scholar
  4. 4.
    Darbyshire JL, Muller-Trapet M, Cheer J, Fazi FM, Young JD (2019) Mapping sources of noise in an intensive care unit. Anaesthesia 74(8):1018–1025PubMedPubMedCentralGoogle Scholar
  5. 5.
    Park M, Kohlrausch A, de Bruijn W, de Jager P, Simons K (2014) Analysis of the soundscape in an intensive care unit based on the annotation of an audio recording. J Acoust Soc Am 135:1875–1886CrossRefGoogle Scholar
  6. 6.
    Daiber A, Kröller-Schön S, Frenis K, Oelze M, Kalinovic S, Vujacic-Mirski K et al (2019) Environmental noise induces the release of stress hormones and inflammatory signaling molecules leading to oxidative stress and vascular dysfunction—Signatures of the internal exposome. BioFactors 45(4):495–506PubMedGoogle Scholar
  7. 7.
    Kamdar BB, Needham DM, Collop NA (2012) Sleep deprivation in critical illness: its role in physical and psychological recovery. J Intensive Care Med 27:97–111CrossRefGoogle Scholar
  8. 8.
    Jha AK, Orav EJ, Zheng J, Epstein AM (2008) Patients’ perception of hospital care in the United States. N Engl J Med 359:1921–1931CrossRefGoogle Scholar
  9. 9.
    Oldham MA, Lee HB, Desan PH (2016) Circadian rhythm disruption in the critically Ill: an opportunity for improving outcomes. Crit Care Med 44:207–217CrossRefGoogle Scholar
  10. 10.
    Pandharipande PP, Ely EW, Arora RC, Balas MC, Boustani MA, La Calle GH, et al. (2017) The intensive care delirium research agenda: a multinational, interprofessional perspective. Intensive Care MedGoogle Scholar
  11. 11.
    Simons KS, Verweij E, Lemmens PMC, Jelfs S, Park M, Spronk PE et al (2018) Noise in the intensive care unit and its influence on sleep quality: a multicenter observational study in Dutch intensive care units. Crit Care 22:250CrossRefGoogle Scholar
  12. 12.
    Delaney L, Litton E, Van Haren F (2019) The effectiveness of noise interventions in the ICU. Curr Opin Anaesthesiol 32:144–149CrossRefGoogle Scholar
  13. 13.
    Goeren D, John S, Meskill K, Iacono L, Wahl S, Scanlon K (2018) Quiet time: a noise reduction initiative in a neurosurgical intensive care unit. Crit Care Nurse 38:38–44CrossRefGoogle Scholar
  14. 14.
    Olson DM, Borel CO, Laskowitz DT, Moore DT, McConnell ES (2001) Quiet time: a nursing intervention to promote sleep in neurocritical care units. Am J Crit Care 10:74–78PubMedGoogle Scholar
  15. 15.
    Menear A, Elliott R, Ma L, Lal S, McKinley S (2017) Repeated sleep-quality assessment and use of sleep-promoting interventions in ICU. Nurs Crit Care 22:348–354CrossRefGoogle Scholar
  16. 16.
    Knauert MP, Redeker NS, Yaggi HK, Bennick M, Pisani MA (2018) Creating naptime: an overnight, nonpharmacologic intensive care unit sleep promotion protocol. J Patient Exp 5:180–187CrossRefGoogle Scholar
  17. 17.
    Kamdar BB, Yang J, King LM, Neufeld KJ, Bienvenu OJ, Rowden AM et al (2014) Developing, implementing, and evaluating a multifaceted quality improvement intervention to promote sleep in an ICU. Am J Med Qual 29:546–554CrossRefGoogle Scholar
  18. 18.
    Litton E, Carnegie V, Elliott R, Webb SA (2016) The efficacy of earplugs as a sleep hygiene strategy for reducing delirium in the ICU: a systematic review and meta-analysis. Crit Care Med 44(5):992–999.  https://doi.org/10.1097/CCM.0000000000001557 CrossRefPubMedGoogle Scholar
  19. 19.
    Locihova H, Axmann K, Padysakova H, Fejfar J (2018) Effect of the use of earplugs and eye mask on the quality of sleep in intensive care patients: a systematic review. J Sleep Res 27:e12607CrossRefGoogle Scholar
  20. 20.
    Luetz A, Weiss B, Penzel T, Fietze I, Glos M, Wernecke KD et al (2016) Feasibility of noise reduction by a modification in ICU environment. Physiol Meas 37:1041–1055CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Pulmonary, Critical Care and Sleep MedicineUniversity of California, San DiegoSan Diego, La JollaUSA
  2. 2.Department of Intensive Care MedicineJeroen Bosch Hospital‘s-HertogenboschThe Netherlands
  3. 3.Department of Intensive Care MedicineGelre Hospitals ApeldoornApeldoornThe Netherlands

Personalised recommendations