Improvement of intensive care unit sound environment and analyses of consequences on sleep: an experimental study

Objective: Uninterrupted sleep is of vital importance for restoration and regaining health. In intensive care units (ICUs) where recovering and healing is crucial, patients' sleep often is fragmented and disturbed due to noise from activities from oneself, other patients, and alarms. The aim of our study was to explore if sleep could be improved by modifying the sound environment in a way that is practically feasible in ICUs. Methods: We studied the effects of originally recorded ICU noise and peak reduced ICU noise on sleep in healthy male participants. Sleep was registered with polysomnography (PSG) during four nights: one adaptation night, one reference (REF) night, and the two exposed nights with similar equivalent sound levels (47 dB L-Aeq) but different maximum sound levels (56- vs 64-dB L-AFmax). The participants answered questionnaires and saliva cortisol was sampled in the morning. Results: During ICU exposure nights, sleep was more fragmented with less slow-wave sleep (SWS), more arousals, and more time awake. The effects of reduced maximum sound level were minor. The subjective data supported the polysomnographic findings, though cortisol levels were not significantly affected by the exposure conditions. Conclusions: Noise in ICUs impairs sleep and the reduction of maximal A-weighted levels from 64 to 56 dB is not enough to have a clear improved effect on sleep quality. (C) 2013 Elsevier B. V. All rights reserved.