***** I think any of us could have written about this!*****

Hospital Noise Fractures Sleep, Slows Healing

By*Crystal Phend, Senior Staff Writer, MedPage Today

Published: June 12, 2012

Reviewed*by*Zalman S. Agus, MD; Emeritus Professor, Perelman School
of Medicine at the University of Pennsylvania.

This study of the effects of sounds on sleep disruption among normal
volunteers in a sleep laboratory found that electronic sounds from
medical equipment were more disruptive than the sounds of human voices
or environmental sounds, such as traffic noise.

Note that when sleep was disrupted, even for a few seconds, heart rates
increased. Sleep disruption occurred most often during rapid eye
movement (REM) sleep, the lightest sleep stage.

Nighttime noise in hospitals adds up to poor sleep, which may hurt
healing when patients need it most, researchers found.

In a laboratory sleep study, recorded hospital sounds of overhead
paging, IV alarms, squeaky carts, and the like disrupted sleep and
raised heart rates, Orfeu M. Buxton, PhD, of Harvard and Brigham and
Women's Hospital in Boston, and colleagues reported.

Electronic alert sounds like ringing phones and IV alarms were the most
"potent" in arousing sleepers, disrupting normal sleep brain wave
patterns more than half of the time, even when set at their quietest

Likewise, staff talking and voice paging at a level of 50 dB -- quieter
than normal conversation -- disrupted sleep half of the time in the
study, which appeared in the June 19 issue of the Annals of Internal

"Preservation of patients' sleep should be a priority for contributing
to improved clinical outcomes for patients who are hospitalized,"
Buxton's group wrote.

Those benefits might include lower sedation requirements and shorter
hospital stays, and even lower incidence of delirium in the intensive
care unit, they suggested.

Many centers contacted by ABC News in collaboration with MedPage Today
have started implementing various strategies to limit night noise, which
is consistently a top complaint from inpatients.

That's important to tackle not only for the sake of patients but also
for the hospital's reputation, Vineet Arora, MD, of the University of
Chicago, commented in an email.

"Noise is a publicly reported quality measure for U.S. hospitals in CMS
Hospital Compare [part of the HCAPS survey] and only half of patients
report their rooms are kept quiet at night," Arora wrote.

Common strategies cited were putting posters or stoplight-style monitors
in hallways to remind staff and visitors to keep voices down, a switch
to visual paging systems, and setting up "quiet time" hours.

The study included 12 healthy adults who slept in a sound-dampened sleep
lab for polysomnography over three nights.

After a run-in night, participants were exposed to 14 common sounds --
such as voices, IV alarm, phone, ice machine, toilet flush, laundry
cart, outside traffic, and helicopter noise -- played at levels
increasing from 40 to 70 dB during specific sleep stages to test the

Sleep was easier to disrupt in the phase after the transition into
sleep, called N2, that adults spend most of their time asleep in,
compared with the next deeper, slow-wave sleep phase called N3 or the
rapid eye movement phase (REM, both P<0.001).

Overall, as expected, louder sounds were more likely to disturb brain
wave patterns during sleep.

Arousal occurred at lower sound levels on the third night than on the
second night, suggesting some sensitization to nighttime noise in the

Heart rate jumped about 10 bpm when a sound fully roused a sleeper.

These results likely underestimated the impact of noise on sleep among
inpatients due to the young population studied, whereas the typical
hospitalized patient is older with medical and psychiatric conditions,
as well as pain and medication use, all of which contribute to a harder
time reaching the deep N3 stage of sleep, Buxton's group cautioned.

Another limitation in that regard was that noise exposure was
sequential, kept to 10 seconds or less, and halted if a participant
started to wake up, which is not the case in a real hospital setting,
the investigators added.

The study was funded by the Academy of Architecture for Health,
Facilities Guidelines Institute, and the Center for Health Design.
Buxton reported receiving grant funds from Sepracor (now Sunovion) and
consulting for Dinsmore LLC as an expert witness.

This article was developed in collaboration with ABC News.

From the American Heart Association:
AHA Science News from EPI/NPAM 2012: Insufficient Sleep Increases
Caloric Intake but not Energy Expenditure

AHA Science News from EPI/NPAM 2011: Gender Modifies the Association
between Sleep Habits and Cardiovascular Disease Risk Factors

Primary source: Annals of Internal Medicine
Source reference:
Buxton OM, et al "Sleep disruption due to hospital noises: a prospective
evaluation" Ann Intern Med 2012; 156.

Donna G.

1) Rejoice always, Pray continually, Give thanks in all circumstances,
For this is God's will for you in Christ Jesus. ( I Thessalonians
5:16-18 NIV )

2) ANGELS EXIST, but some times, since they don't all have wings, we
call them FRIENDS......

3) Just because you're in pain, doesn't mean you have to be one!