Sleep in intensive care unit: The role of environment

Boyko, Yuliya; Jennum, Poul; Nikolic, Miki; Holst, René; Oerding, Helle; Toft, Palle

doi:10.1016/j.jcrc.2016.09.005

Cited by 62 publications

(49 citation statements)

References 27 publications

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“…The standard measure of environmental noise, the average daily sound pressure levels value (LAeq24), is insufficiently detailed to enable targeted noise‐reduction interventions in an ICU. This may be one of the reasons why the majority of sound reduction studies conducted in ICUs have not resulted in significant change . This study was designed to identify spatial positioning of sound sources within an ICU.…”

Section: Discussionmentioning

confidence: 99%

Mapping sources of noise in an intensive care unit

et al. 2019

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Summary Excessive noise in hospitals adversely affects patients’ sleep and recovery, causes stress and fatigue in staff and hampers communication. The World Health Organization suggests sound levels should be limited to 35 decibels. This is probably unachievable in intensive care units, but some reduction from current levels should be possible. A preliminary step would be to identify principal sources of noise. As part of a larger project investigating techniques to reduce environmental noise, we installed a microphone array system in one with four beds in an adult general intensive care unit. This continuously measured locations and sound pressure levels of noise sources. This report summarises results recorded over one year. Data were collected between 7 April 2017 and 16 April 2018 inclusive. Data for a whole day were available for 248 days. The sound location system revealed that the majority of loud sounds originated from extremely limited areas, very close to patients’ ears. This proximity maximises the adverse effects of high environmental noise levels for patients. Some of this was likely to be appropriate communication between the patient, their caring staff and visitors. However, a significant proportion of loud sounds may originate from equipment alarms which are sited at the bedside. A redesign of the intensive care unit environment to move alarm sounds away from the bed‐side might significantly reduce the environmental noise burden to patients.

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Section: Discussionmentioning

confidence: 99%

Mapping sources of noise in an intensive care unit

et al. 2019

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“…All the patients had Richmond Agitation-Sedation (RASS) score at inclusion from -1 to +1. Nine of the patients included at Vejle ICU periodically received small doses of remifentanil analgosedation during the participation period to reduce the irritation from endotracheal tube [15]. The patients included at Odense ICU received no continuous sedation during the period of PSG recording that was used for the survival analysis [16].…”

Section: Resultsmentioning

confidence: 99%

“…The absence of sleep characteristics as defined in AASM standard for sleep scoring and the presence of atypical sleep patterns according to Watson's classification [11] were found in many patients in our two previous PSG studies in conscious critically ill patients on mechanical ventilation [15,16]. The role of the absence of normal sleep characteristics in sleep EEG for the outcome in these critically ill patients is unknown.…”

Section: Introductionmentioning

confidence: 91%

“…Denmark. The patients used in this study also participated in one of the following two studies 'Sleep in critically ill patients: the role of environment', registered on ClinicalTrials.gov (NCT01681043) [15], and 'Sleep in critically ill, mechanically ventilated patients with severe sepsis or COPD', registered on ClinicalTrials.gov (NCT02434341) [16]. Both studies were approved by the Regional Ethics Committee of Southern Denmark (S-20120001; S-20140207G), and performed in accordance with principles of the Declaration of Helsinki and rules of Good Clinical Practice.…”

Section: Patientsmentioning

confidence: 99%

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Atypical sleep in critically ill patients on mechanical ventilation is associated with increased mortality

et al. 2018

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“…6,7 Various noises especially disturb sleep of inpatients at hospitals. 8,9 In previous literatures, values of noise index were usually averaged out to present the status of environmental noise. However, since the daily variation in environmental noise is common, the mean values of noise indices are not the exact noise level at a certain time.…”

Section: Introductionmentioning

confidence: 99%

Environmental Noise and Sleep Disturbance: Night-to-Night Variability of Sleep/Wake Pattern

et al. 2016

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Actigraphy is useful to assess sleep pattern of subjects for several days to several weeks, and collected sleep data is usually averaged out to know the general sleep pattern of each individual. However, intra-individual variability should be considered when assessing sleep patterns, with regard to the phenomenon of daily fluctuation. The aim of this study was to explore whether the mean sleep indices reflect intra-individual variability with regard to environmental noise. Indoor noise and sleep pattern were collected over 5 days, among 22 citizens of Ulsan Metropolitan city. We observed an association between environmental noise indices and various sleep indices such as sleep efficiency, number of awakenings, or fragmentation indices when we analyzed the data of 108 nights from 22 subjects. However, the significances were weakened when we analyzed noise and sleep/wake pattern after averaging out. In conclusion, we observed that the sleep/ wake pattern over several days to weeks should not be averaged out when studied in relation with variable physiological phenomena, such as night-tonight variability.

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Sleep in intensive care unit: The role of environment

Cited by 62 publications

References 27 publications

Mapping sources of noise in an intensive care unit

Mapping sources of noise in an intensive care unit

Atypical sleep in critically ill patients on mechanical ventilation is associated with increased mortality

Environmental Noise and Sleep Disturbance: Night-to-Night Variability of Sleep/Wake Pattern

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