The “Sound of Silence” in a Neonatal Intensive Care Unit—Listening to Speech and Music Inside an Incubator

Abstract

Background: The intrauterine hearing experience differs from the extrauterine hearing exposure within a neonatal intensive care unit (NICU) setting. Also, the listening experience of a neonate drastically differs from that of an adult. Several studies have documented that the sound level within a NICU exceeds the recommended threshold by far, possibly related to hearing loss thereafter. The aim of this study was, first, to precisely define the dynamics of sounds within an incubator and, second, to give clinicians and caregivers an idea about what can be heard "inside the box." Methods: Audio recordings within an incubator were conducted at the Pediatric Simulation Center of the Medical University Vienna. They contained recorded music, speech, and synthesized sounds. To understand the dynamics of sounds around and within the incubator, the following stimuli were used: broadband noise with decreasing sound level in 10 steps of 6 dB, sine waves (62.5,

Newborn Incubators Do Not Protect from High Noise Levels in the Neonatal Intensive Care Unit and Are Relevant Noise Sources by Themselves

“…Although there may be interindividual, situational, and cultural differences with respect to the definition of a pleasant or unpleasant acoustic surrounding, there is still a consensus that humans generally prefer clear rather than distorted sounds [68]. Our findings are in line with similar studies that identified a noise generation between 80 and 90 dB(A) due to the incubator opening or closing, which have been reviewed extensively [69,70]. Unfortunately, these findings do not comply with the recommendations to maintain the combination of background and operational sound within an hourly equivalent continuous sound pressure level (SPL, Leq) of 50 dB, referring to a weighted slow response.…”

Level and Noise Sources in the Neonatal Intensive Care Unit of a Reference Hospital

“…Beneficial sounds should be included, such as soft and modulated voices from the parents and from the staff in charge, given that recognizing sounds of human voices favors language development. ( 12 , 21 ) Periodical samplings of the noise levels are suggested to compare if the actions implemented contribute to diminish such.…”

The Effect of Music on aEEG Cyclicity in Preterm Neonates

“…Finally, both types of music intervention had an impact on quality of QS in our study. However, even when considering the complex NICU setting [ 17 , 45 ], actual music therapy protocols [ 31 ] underline the psychosocial aspect of music therapy in the NICU by including and working together with the parents when possible. Haslbeck and colleagues [ 31 ] referred to the word “empowerment” when describing what could be achieved by music therapists and parents through communicative musicality, when looking at infants individual needs and responsiveness to music.…”

“…Even considering the difficult setting in which premature infants are hospitalized [ 17 ], evidence for the efficacy of music therapy on brain development is emerging [ 24 , 32 ], as are emerging standard protocols for music therapy in the NICU [ 31 ]. This study adds more evidence to the effect of music on aEEG activity in preterm infants, and suggests that music might contribute to an improved quality of hospitalization in these patients.…”

“…According to a study by Kern and colleagues [ 15 ] investigating the role of music therapy worldwide, only a few resources have been identified in the field of pediatric intensive care. The factors behind this evidence could be several, including: the difficulty in implementing such therapy in this type of setting (e.g., hygienic reasons, noisy environment [ 17 ]); critical condition of the patients (e.g., requiring isolation); and financial priority of the actual medical system.…”