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)...


Compliance with ethical standards

Conflicts of interest

All authors report no conflicts of interest.


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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

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