Systematic review of the effects of intensive-care-unit noise on sleep of healthy subjects and the critically ill

Abstract

Intensive-care-unit (ICU) patients exhibit disturbed sleeping patterns, often attributed to environmental noise, although the relative contribution of noise compared to other potentially disrupting factors is often debated. We therefore systematically reviewed studies of the effects of ICU noise on the quality of sleep to determine to what extent noise explains the observed sleep disruption, using the Cochrane Collaboration method for non-randomized studies. Searches in Scopus, PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library were conducted until May 2017. Twenty papers from 18 studies assessing sleep of adult patients and healthy volunteers in the ICU environment, whilst recording sound levels, were included and independently reviewed by two reviewers. We found that the numbers of arousals between the baseline and the ICU noise condition in healthy subjects differed significantly (mean difference 9.59; 95% confidence interval 2.48-16.70). However, there was considerable heterogeneity between studies (I 94%, P < 0.00001), and all studies suffered from a considerable risk of bias. The meta-analysis of results was hampered by widely varying definitions of sound parameters between studies and a general lack of detailed description of methods used. It is, therefore, currently impossible to quantify the extent to which noise contributes to sleep disruption among ICU patients, and thus, the potential benefit from noise reduction remains unclear. Regardless, the majority of the observed sleep disturbances remain unexplained. Future studies should, therefore, also focus on more intrinsic sleep-disrupting factors in the ICU environment.

The importance of the intensive care unit environment in sleep—A study with healthy participants

“…The sound measurement results of the current study show that our ICU may not be as noisy as other ICUs reported in past publications (Horsten et al, ). There are several potential reasons for this.…”

“…However, noise has only indirectly been linked to sleep disruption in ICU patients, and the differences between patients are not well understood (Aaron et al, 1996;Freedman et al, 1999;Gabor et al, 2003;Xie et al, 2009). Furthermore, these patient studies were hampered by small sample sizes, low quality of evidence and high risks of bias, further limiting the generalizability of their results (Horsten, Reinke, Absalom, & Tulleken, 2018).…”

Mapping sources of noise in an intensive care unit

“…Intensive care units are particularly noisy areas of hospitals . Neonatal units have average sound pressure levels of 48–61 dB for up to 95% of the time , paediatric units average 53–73 dB and adult units are 53–59 dB . The unit at the John Radcliffe Hospital when measured in 2012 had daytime averages of 58 dB at the desk and 60 dB adjacent to the patient .…”

“…Excessive noise in ICUs disrupts patients’ sleep , increases sleep medication use , sedation use and the incidence of delirium . Ambient sound markedly reduces the intelligibility of speech in acute care areas , which can contribute to avoidable errors in care.…”

Explorando Internet das Coisas e Inteligência Artificial no contexto de Saúde em Casas Inteligentes: uma abordagem física e emocional

“…Pesquisas (YAO et al, 2008;CEOLIM, 2013;HORSTEN et al, 2018) nesse sentido buscam o entendimento de fatores que afetam positivamente ou negativamente na qualidade do sono de indivíduos, destacando-se: a iluminação intensa, ocorrência de ruídos e movimentação durante o período noturno. Assim, as informações básicas abordadas neste estudo são: i.)…”