An experimental model to measure the ability of headphones with active noise control to reduce patient’s exposure to noise in an intensive care unit

Abstract

BackgroundDefining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce patient’s exposure to noise. Active noise control devices may prove to be useful adjuncts but there is currently little to quantify their ability to reduce noise in this complex environment.MethodsSound meters were embedded in the auditory meatus of three polystyrene model heads with no headphones (control), with headphones alone and with headphones using active noise control and placed in patient bays in a cardiac ICU. Ten days of recording sound levels at a frequency of 1 Hz were performed, and the noise levels in each group were compared using repeated measures MANOVA and subsequent pairwise testing.ResultsMultivariate testing demonstrated that there is a significant difference in the mean noise exposure levels between the three groups (p < 0.001). Subsequent pairwise testing between the three groups shows that the reduction in noise is greatest with headphones and active noise control. The mean reduction in noise exposure between the control and this group over 24 h is 6.8 (0.66) dB. The use of active noise control was also associated with a reduction in the exposure to high-intensity sound events over the course of the day.ConclusionsThe use of active noise cancellation, as delivered by noise-cancelling headphones, is associated with a significant reduction in noise exposure in our model of noise exposure in a cardiac ICU. This is the first study to look at the potential effectiveness of active noise control in adult patients in an intensive care environment and shows that active noise control is a candidate technology to reduce noise exposure levels the patients experience during stays on intensive care.

Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome

“…Noise-canceling headsets can deliver personalized music in addition to reducing noise exposure. 59 Another option is the use of directional speakers which allow for individualized music selection without excessively disturbing neighboring patients. These can be installed either in the patient's vicinity (e.g., around pillow) or through bed-or ceiling-mounted versions.…”

The Impact of Environmental Risk Factors on Delirium and Benefits of Noise and Light Modifications: A Scoping Review

“…Perceived night-time noise was improved, but with no effect on sleep quality or use of delirium Our full-text review and data extraction appraised articles studying single-component noise control strategies, such as behavioral programs [62][63][64][65][66] , earplugs or noise cancelling headphones [67][68][69][70][71] , and headphones equipped with an alarm filtering system 72 ; however these were not included since they reviewed the impact of interventions on the level of noise or quality of sleep, but delirium was not reported as an outcome (Excluded studies; Supplementary Table 3).…”

Sleeping Soundlessly in the Intensive Care Unit

“…Without substantially altering the clinical staff's responsibilities, non-pharmaceutical sleep-promoting interventions such as earplugs and eye masks were found to have some benefit on sleep and prevention of delirium [43]. Another study by Gallacher et al found that noise-canceling headphones reduced sound exposure by a mean 6.8 dB for a patient [44]. This reduction does not necessarily decrease the sound environment down to the WHO accepted 30 dB, but it is nonetheless an improvement.…”