title: Sleep disruption due to hospital noises: a prospective evaluation.
abstract: BACKGROUND
  Sleep plays a critical role in maintaining health and well-being; however, patients who are hospitalized are frequently exposed to noise that can disrupt sleep. Efforts to attenuate hospital noise have been limited by incomplete information on the interaction between sounds and sleep physiology.
  
  
  OBJECTIVE
  To determine profiles of acoustic disruption of sleep by examining the cortical (encephalographic) arousal responses during sleep to typical hospital noises by sound level and type and sleep stage.
  
  
  METHODS
  3-day polysomnographic study.
  
  
  METHODS
  Sound-attenuated sleep laboratory.
  
  
  METHODS
  Volunteer sample of 12 healthy participants.
  
  
  METHODS
  Baseline (sham) night followed by 2 intervention nights with controlled presentation of 14 sounds that are common in hospitals (for example, voice, intravenous alarm, phone, ice machine, outside traffic, and helicopter). The sounds were administered at calibrated, increasing decibel levels (40 to 70 dBA [decibels, adjusted for the range of normal hearing]) during specific sleep stages.
  
  
  METHODS
  Encephalographic arousals, by using established criteria, during rapid eye movement (REM) sleep and non-REM (NREM) sleep stages 2 and 3.
  
  
  RESULTS
  Sound presentations yielded arousal response curves that varied because of sound level and type and sleep stage. Electronic sounds were more arousing than other sounds, including human voices, and there were large differences in responses by sound type. As expected, sounds in NREM stage 3 were less likely to cause arousals than sounds in NREM stage 2; unexpectedly, the probability of arousal to sounds presented in REM sleep varied less by sound type than when presented in NREM sleep and caused a greater and more sustained elevation of instantaneous heart rate.
  
  
  CONCLUSIONS
  The study included only 12 participants. Results for these healthy persons may underestimate the effects of noise on sleep in patients who are hospitalized.
  
  
  CONCLUSIONS
  Sounds during sleep influence both cortical brain activity and cardiovascular function. This study systematically quantifies the disruptive capacity of a range of hospital sounds on sleep, providing evidence that is essential to improving the acoustic environments of new and existing health care facilities to enable the highest quality of care.
  
  
  BACKGROUND
  Academy of Architecture for Health, Facilities Guidelines Institute, and The Center for Health Design.
authors.affiliation: Harvard Medical School, Brigham and Women’s Hospital, Massachusetts General Hospital, and Berklee College of Music, Boston, MA, USA. orfeu_buxton@hms.harvard.edu
authors.forename: Orfeu M
authors.initials: OM
authors.lastname: Buxton
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Ellenbogen
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Andy
authors.initials: A
authors.lastname: Carballeira
authors.forename: Shawn
authors.initials: S
authors.lastname: O'Connor
authors.forename: Dan
authors.initials: D
authors.lastname: Cooper
authors.forename: Ankit J
authors.initials: AJ
authors.lastname: Gordhandas
authors.forename: Scott M
authors.initials: SM
authors.lastname: McKinney
authors.forename: Jo M
authors.initials: JM
authors.lastname: Solet
mesh_terms: D000161:Acoustic Stimulation; D004569:Electroencephalography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D009622:Noise / Q000009:adverse effects*; D017286:Polysomnography; D011446:Prospective Studies; D012894:Sleep Stages / Q000502:physiology*; D014851:Wakefulness / Q000502:physiology; D055815:Young Adult