Night-time Noise Levels and Patients’ Sleep Experiences in a Medical Assessment Unit in Northern England

Background: Hospital in-patients need sleep so that restorative process and healing can take place. However, over one third of in-patients experience sleep disturbance, often caused by noise. This can compromise patients’ perceptions of care quality and cause physical and psychological ill health. Aims: To assess 1) in-patients sleep quality, quantity, reported sources of sleep disturbance and their suggestions for improvement 2) objectively measure decibel levels recorded at night. Methods: This descriptive study conducted in a Medical Assessment Unit used multi-methods; a semi-structured ‘sleep experience’ questionnaire administered to a purposive sample of in-patients; recording of night-time noise levels, on 52 consecutive nights, using two calibrated Casella sound level meters. Results: Patient ratings of ‘in-hospital’ sleep quantity (3.25; 2.72 SD) and quality (2.91; 2.56 SD) was poorer compared to ‘home’ sleep quantity (5.07; 2.81 SD) and quality (5.52; 2.79 SD). The difference in sleep quality (p<0.001) and quantity (p<0.001) ratings whilst in hospital, compared to at home, was statistically significant. Care processes, noise from other patients and the built environment were common sources of sleep disturbance. Participants’ suggestions for improvement were similar to interventions identified in current research. The constant noise level ranged from 38-57 decibels (equivalent to an office environment), whilst peak levels reached a maximum of 116 decibels, (equivalent to banging a car door one metre away). Conclusion: The self-rated patient sleep experience was significantly poorer in hospital, compared to home. Noise at night contributed to sleep disturbance. Decibel levels were equivalent to those reported in other international studies. Data informed the development of a ‘Sleep Smart’ toolkit designed to improve the in-patient sleep experience.

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Appraisal of Noise Level Dissemination Surrounding Mining and Industrial Areas of Keonjhar, Odisha: a Comprehensive Approach Using Noise Mapping

Archives of Acoustics ◽

10.1515/aoa-2017-0044 ◽

2017 ◽

Vol 42 (3) ◽

pp. 423-432 ◽

Cited By ~ 2

Author(s):

Satish K. Lokhande ◽

Satyajeet A. Dhawale ◽

Samir S. Pathak ◽

Rakesh Gautam ◽

Mohindra C. Jain ◽

...

Keyword(s):

Noise Level ◽

Sound Level ◽

Noise Levels ◽

Night Time ◽

Noise Mapping ◽

High Noise ◽

Sensitive Areas ◽

Sound Levels ◽

Directorate General ◽

Open Cast

Abstract Noise mapping is a well-established practice among the European nations, and it has been follow for almost two decades. Recently, as per guidelines of the Directorate General of Mines Safety (DGMS), India, noise mapping has been made mandatory in the mining expanses. This study is an effort to map the noise levels in nearby areas of mines in the northern Keonjhar district. The motive of this study is to quantify the existing A-weighted time-average sound level (LAeq,T ) in the study area to probe its effects on the human dwellings and noise sensitive areas with the probability of future development of the mines, roads, and industrial and commercial zone. The LAeq,T was measured at 39 identified locations, including industrial, commercial, residential, and sensitive zones, 15 open cast mines, 3 major highways, and 3 haulage roads. With the utilisation of Predictor LimA Software and other GIS tools, the worked out data is mapped and noise contours are developed for the visualisation and identification of the extent and distribution of sound levels across the study area. This investigation discloses that the present noise level at 60% of the locations in silence and residential zone exposed to significantly high noise levels surpasses the prescribed limit of Central Pollution Control Board (CPCB), India. The observed day and night time LAeq, T level of both zones ranged between 43.2-62.2 dB(A) and 30.5-53.4 dB(A), respectively, whereas, the average Ldn values vary between 32.7 and 51.2 dB(A). The extensive mobility of heavy vehicles adjoining the sensitive areas and a nearby plethora of open cast mines is the leading cause of exceeded noise levels. The study divulges that the delicate establishments like schools and hospitals are susceptible to high noise levels throughout the day and night. A correlation between observed and software predicted values gives R2 of 0.605 for Ld, 0.217 for Ln, and 0.524 for Ldn. Finally, the mitigation measure is proposed and demonstrated using a contour map showing a significant reduction in the noise levels by 0-5.3 dB(A).

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1209 Effect Of Wearables On Sleep In Healthy Individuals: A Randomized Cross-over Trial And Validation Study

SLEEP ◽

10.1093/sleep/zsaa056.1203 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A462-A462 ◽

Cited By ~ 1

Author(s):

S Berryhill ◽

C J Morton ◽

A Dean ◽

A Berryhill ◽

N Provencio-Dean ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Disturbance ◽

Slow Wave Sleep ◽

Order Effect ◽

Community Based ◽

Precision Error ◽

Sleep Quantity ◽

Sleep Logs ◽

Improve Sleep Quality ◽

Nighttime Sleep

Abstract Introduction To determine whether a wearable sleep-tracker improves perceived sleep quality in healthy subjects. To test whether wearables reliably measure sleep quantity and quality compared to polysomnography. Methods A single-center randomized cross-over trial of community-based participants without medical conditions or sleep disorders. Wearable device (WHOOP, Inc.) that provided feedback regarding sleep information to the participant for 1-week and maintaining sleep logs versus 1-week of maintaining sleep logs alone. Self-reported daily sleep behaviors were documented in sleep logs. Polysomnography was performed on one night when wearing the wearable. PROMIS Sleep disturbance sleep scale was measured at baseline, 7, and 14 days of study participation. Results In 32 participants (21 women; 23.8 + 5 years), wearables improved nighttime sleep quality (PROMIS sleep disturbance; B= -1.69; 95% Confidence Interval -3.11, -0.27; P=0.021) after adjusting for age, sex, baseline, and order effect. There was a small increase in self-reported daytime naps when wearing the device (B = 3.2; SE 1.4; P=0.023) but total daily sleep remained unchanged (P=0.43). The wearable had low bias (2.5 minutes) and low precision (5.6 minutes) errors for measuring sleep duration and measured dream sleep and slow wave sleep accurately (Intra-class coefficient 0.74 + 0.28 and 0.85 + 0.15, respectively). Bias and precision error for heart rate (bias -0.17%; precision 1.5%) and respiratory rate (bias 1.8%’ precision 6.7%) were very low when compared to that measured by electrocardiogram and inductance plethysmography during polysomnography. Conclusion In healthy people, wearables can improve sleep quality and accurately measure sleep and cardiorespiratory variables. Support WHOOP Inc.

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An Assessment of Sleep Disturbance in Patients before and after Carpal Tunnel Release

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835519500188 ◽

2019 ◽

Vol 24 (02) ◽

pp. 144-146 ◽

Cited By ~ 1

Author(s):

John Erickson ◽

Daniel Polatsch ◽

Steven Beldner ◽

Eitan Melamed

Keyword(s):

Sleep Quality ◽

Sleep Disturbance ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Continuous Variables ◽

Night Time ◽

Before And After ◽

Tunnel Syndrome ◽

English Speaking

Background: Night time numbness is a key characteristic of CTS and relief of night time symptoms is one of the outcomes most important to patients. This study tested the null hypothesis that there is no difference between sleep quality and night symptoms before and after carpal tunnel release (CTR). Methods: Forty-four, English-speaking adult patients requesting open CTR for electrodiagnostically confirmed carpal tunnel syndrome completed questionnaires before and after surgery. Average age was 59, 24 patients were men and 20 were women. Patient with a primary or secondary sleep disorder were excluded. Before surgery, patients completed the Pittsburg Sleep Quality index (PSQI). At an average of 3 months after surgery, participants completed PSQI questionnaires. Onset of sleep quality improvement was specifically addressed. Differences between preoperative and postoperative sleep quality were evaluated using the paired t-test. Spearman correlations were used to assess the relationship between continuous variables. Results: Of the 44 patients, 32 (72%) were classified as poor sleepers (PSQI > 5.5) prior to surgery. At 3 months follow up, there was a significant improvement PSQI global scores (7.8 ± 5.1 vs 4 ± 3.5, p < 0.001) as well as subdivisions. Daytime dysfunction (0.2 ± 0.4, p < 0.001) and medication use (1.0 ± 1.2 vs 0.9 ± 1.2, p < 0.045) secondary to sleep disturbance and was improved as well. In all patients, onset of improvement was within 24 hours of surgery. Conclusions: CTR is associated with improvement in sleep quality at 3 months follow-up. CTR improves daytime dysfunction related to the sleep disturbance. The onset of sleep improvement is 24 hours after surgery in most cases.

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261 Sleep and Frailty: Examining the Effects of Frailty on Sleep Disturbance in Hospitalised Older Adults

Age and Ageing ◽

10.1093/ageing/afz102.60 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii1-iii16

Author(s):

Helen Mannion ◽

Rónán O'Caoimh

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Sleep Disturbance ◽

Cognitive Status ◽

University Hospital ◽

Charlson Comorbidity Index Score ◽

Night Time ◽

Clinical Frailty Scale ◽

Prolonged Length ◽

Frail Patients

Abstract Background Sleep disturbance is common in hospital, potentially resulting in poor clinical outcomes. Frailty is similarly prevalent and associated with multiple adverse events. Despite this, little is known about the interaction between frailty and sleep among older hospital inpatients. Methods Consecutive, non-critically ill patients aged ≥70, admitted medically through a large university hospital emergency department (ED) during the preceding 24 hours, were evaluated with measures assessing overnight sleep quality (Richards Campbell Sleep Questionnaire/RCSQ), baseline sleep (Pittsburgh Sleep Quality Index/PSQI) and insomnia (Insomnia Severity Index/ISI). Additional variables included medications, frailty (PRISMA-7 scores ≥3 and Clinical Frailty Scale/CFS scores ≥5), functional and cognitive status, and night-time noise levels. Patients were reassessed 48 hours later. Results Over four weeks, 152 patients, mean age 80 (±6.8) years were included; 61% were male (n=92). In all, 43% were frail (mean CFS score 4.23±1.6), median PRISMA-7 score 4±4; a further 24% were pre-frail. The median Charlson Comorbidity Index score was 6±2. The majority, 72% (110/152), reported impaired baseline sleep quality (PSQI ≥5) and 13% (20/152) had clinical insomnia (ISI ≥15). The median time spent in ED was 23±13 hours, median duration asleep was only one hour (range 0-8). After adjusting for possible confounders, frailty status was significantly associated with lower PSQI (p<0.001) but not ISI (p=0.07) and RCSQ (p=0.07) scores. Frail patients were twice as likely to report poor baseline sleep OR 2, (95% CI:1.3-3.2). Baseline and overnight sleep disturbance were not associated with prolonged length of stay (LOS) or 30-day readmission rates. Conclusion The prevalence of sleep disturbance and clinical insomnia among older adults admitted through ED is high and overnight sleep quality low, although these did not impact on LOS or 30-day re-admission rates. Frail patients reported significantly poorer baseline sleep but did not have higher rates of insomnia or experience worse overnight sleep.

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2D and 3D mapping of traffic induced noise near major roads passing through densely populated residential area of South Delhi, India

PLoS ONE ◽

10.1371/journal.pone.0248939 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248939

Author(s):

Pervez Alam ◽

Kafeel Ahmad ◽

Afzal Husain Khan ◽

Nadeem A. Khan ◽

Mohammad Hadi Dehghani

Keyword(s):

Noise Level ◽

Noise Exposure ◽

Standard Procedure ◽

Sound Level ◽

Exposure Level ◽

Residential Areas ◽

Noise Levels ◽

Night Time ◽

Noise Mapping ◽

Regulatory Standards

Noise monitoring and mapping is the critical processes to ensure that the noise level does not reach the harmful levels and provides noise exposure level details. 2-D and 3-D noise mapping has been carried out at pre-selected critical locations of major roads passing through densely populated residential areas, namely, Mathura Road, Lodhi Road, Lala Lajpat Rai Road, and Ring road, along with significant intersections, viz. Moolchand, Ashram, Sabz Burj, and Lodhi road. The monitoring has been performed during the day and night’s peak traffic hours using Sound Level Meter (SLM) Larson & Davis 831as per standard procedure. Then after, 2-D and 3-D noise maps have been prepared, visualized, and analyzed by soundPLAN (acoustic) and MapInfo Pro (Desktop GIS). The maximum noise level is observed at Ashram Chowk [81.1 dB (A)] at 8 pm; however, the minimum noise level is found to be at Lala Lajpat Rai Road [76.4dB (A)] at 7 pm. Monitoring results of noise level show non-compliance of regulatory standards for day time and night time. 2-D noise maps revealed that the noise level is maximum at the centerline of the road and decreases either side with the distance, and remains above the permissible limits at all locations. However, the 3-D noise maps show horizontal as well as vertical noise levels at all locations. The 3-D noise maps also revealed a noise level of 70 dB (A) up to a height of 6.096m at the Ashram Chowk and Moolchand intersection. However, a noise level of 65 dB (A) has been observed at the height of 5.486m at Lala Lajpat Rai Marg and Sabz Burj. This study will explore noise levels in both horizontal and vertical directions near roads surrounded by high-rise buildings. It will help the decision-makers take remedial measures.

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Sleep Disturbance and Rotator Cuff Tears: A Systematic Review

Medicina ◽

10.3390/medicina55080453 ◽

2019 ◽

Vol 55 (8) ◽

pp. 453 ◽

Cited By ~ 4

Author(s):

Longo ◽

Facchinetti ◽

Marchetti ◽

Candela ◽

Ambrogioni ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Sleep Quality ◽

Sleep Disturbance ◽

Sleep Disorders ◽

Assessment Tool ◽

Rotator Cuff Tears ◽

Night Time ◽

Simple Shoulder Test

Background and Objectives: Sleep disorders are one of the most common complaints of patients with rotator cuff (RC) tears. However, potential correlations between the treatment of RC tears and the causal factors of sleep disorders are still under discussion. The aim of this review is to evaluate quality of sleep in patients before and after surgery for RC tears and to identify which factors affected patients’ sleep. Materials and Methods: A systematic review was conducted. To provide high quality of the review, the included studies were evaluated with the standardized tool “Quality Assessment Tool for Quantitative Studies” developed by the Effective Public Health Practice Project. Results: The search strategy yielded 78 articles. After duplicate removal and titles, abstracts and full-texts review, four studies were included in the systematic review. Concerning shoulder function, the most frequently reported scale was the Simple Shoulder Test (SST). Regarding sleep quality, the most frequently reported score was the Pittsburgh Sleep Quality Index (PSQI). Conclusion: We found that the majority of patients with RC tears had a sleep disturbance, especially before surgery with a general improvement in sleep quality post-operatively. Moreover, sleep quality was correlated with pain and it also seems that factors as comorbidities, obligatory position during night time, preoperative and prolonged postoperative use of narcotics and psychiatric issues may play an important role in sleep quality.

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Sleep and its management in dementia

Reviews in Clinical Gerontology ◽

10.1017/s095925980600205x ◽

2006 ◽

Vol 16 (1) ◽

pp. 59-70 ◽

Cited By ~ 3

Author(s):

Eamonn Eeles

Keyword(s):

Circadian Rhythm ◽

Sleep Quality ◽

Sleep Disturbance ◽

Functional Decline ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Behavioural Disturbance ◽

Night Time ◽

Clinically Significant ◽

Over Time

Sleep disturbance is a clinically significant problem in nearly one half of patients with dementia and is a predictor of cognitive and functional decline. There are multiple causes of sleep disturbance in dementia and all represent diagnostic and management challenges. Impaired circadian rhythm is a disorder characterized by an increase in daytime sleep with reduced night-time sleep, a reversal of the sleep/wake cycle. Such disrupted circadian rhythm may occur early in Alzheimer's disease, worsen over time, and is associated with behavioural disturbance, including aggression. In addition to the timing of sleep, the structure of sleep may deteriorate, giving rise to poor sleep quality.

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Noise Levels in a Medical Intensive Care Unit

10.20944/preprints201807.0588.v1 ◽

2018 ◽

Author(s):

Jinyi He ◽

Hong Li ◽

Xiaohuan Chen ◽

Shuang Jin ◽

Meirong Chen ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Medical Intensive Care Unit ◽

Sound Level ◽

Noise Levels ◽

Laptop Computer ◽

Night Time ◽

Cross Sectional ◽

Significant Difference ◽

Medical Intensive Care

This study was undertaken to investigate and analyze noise pollution in a large Chinese governmental hospital’s medical intensive care unit and compare to the WHO guidelines.This cross-sectional study was conducted in a MICU at a public governmental teaching hospital in Fujian province between July and August of 2017. A WENSN® WS1361 Integrated Sound Level Meter (China) was used for continuous every five seconds one week noise levels recording. After this measurement, the decibel meter was used for recording different location of isolation rooms and open bays, including occupied and unoccupied patient, and recording sound events occurs in the ICU to identify sources of noise. Peak and average noise levels were obtained from the meter, and data were downloaded from the WS1361 into a laptop computer. The measured mean equivalent sound pressure levels (L) and standard Aeq deviation over one week period were 66.64±7.57 dB(A), with acute spikes reaching 119.7 dB(A), the average sound level for a 24 hour period in a work day was 68.03±5.07 dB(A). These are higher than the current daytime environmental noise limit of 40-45 decibels in China and WHO. Mean work day noise was significantly louder than weekend time, there was a significant difference in work days and weekend (t=16.85;P=0.000).There was a statistical difference between the day time and night time shifts (t=34.67;P=0.000). The isolation rooms were significantly quieter than the open-bay rooms(t=46.15; p=0.00), sound levels in the occupied and unoccupied rooms also had significant difference(t=17.26; P=0.000).Two types of noise resources, including twenty kinds sources were identified and measured, mean noise levels ranged from of 61.33 to 79.21 dB(A). This study shows noise levels in intensive care units were exceeded the recommended. The study of the influence of noise on patient and staff is needed, and noise reduction strategies must be conduct in ICU.

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Investigating sleep quality on an inpatient psychiatry ward

BJPsych Open ◽

10.1192/bjo.2021.525 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S195-S195

Author(s):

Joshua Hughes ◽

Rhianne Thomas ◽

Jonathan Macklin ◽

Jonathan Owen

Keyword(s):

Sleep Quality ◽

Sleep Disturbance ◽

Psychiatric Symptoms ◽

Low Cost ◽

Poor Sleep ◽

Post Intervention ◽

Factors Affecting ◽

Sleep Quantity ◽

Inpatient Settings ◽

Sleep Length

AimsSleep is essential for optimal physiological functioning, but often interrupted in hospital settings. Disturbed sleep is associated with relapse of mood disorders and multiple comorbidities including impaired immunological function and increased cardiovascular risk. There are unique environmental challenges on psychiatry wards, such as overnight monitoring. Recent studies highlight the importance of evaluating and managing inpatient sleep disturbance. Aims include exploring the extent to which patients’ sleep is impacted by inpatient admission, elucidating causes of sleep disturbance and determining ways to improve sleep during admission.MethodPatients aged 18–65 years, who consented and were expected to be inpatients for a week, were approached after 72 hours of admission (n = 35). Quantitative and qualitative data, including on pre-hospital and hospital sleep quantity and quality, were gathered, as part of a cohort characterisation. Questionnaires using Pittsburgh Sleep Quality Index elements were used to gather data. Offering earplugs as a sleep-aid intervention was implemented, with sleep quantity and quality reassessed 72 hours post-intervention. In response to feedback, sound monitoring at regular intervals overnight was undertaken using a decibel-metre to determine noise baseline and variation.ResultAll patients approached agreed to participate. Pre-hospital average sleep quantity was 5.2 hours, with restedness score of 4.3, and 71% patients rating their sleep as ‘bad’. After 72 hours post-admission, average sleep length was 6.5 hours and restedness 5.3. Of patients who accepted earplugs (59%), there were improvements to mean sleep quality and quantity (7.6 hours), with 86% patients rating earplugs helpful. All patients surveyed thought that earplugs should be offered routinely on admission. 70% of patients were prescribed benzodiazepines or z-drugs as required. Self-reported factors affecting sleep included noise, psychiatric symptoms and medication side effects, with 13 patients mentioning the former. Sound monitoring recorded an average decibel level with a range of 35–75 dB, with peaks reaching 95 dB.ConclusionPoor sleep in hospital is widespread. There is a need to understand and address modifiable environmental and ward factors implicated in sleep disturbance within inpatient settings. Pharmacological options for sedation are common, but it is important to focus on alternative options of low-cost, non-pharmacological interventions which promote sleep optimisation and enhance inpatient care.

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Gender differences in adolescent sleep disturbance and CBT-I treatment response: Exploratory study. (Preprint)

10.2196/preprints.22498 ◽

2020 ◽

Author(s):

Sophie H Li ◽

Bronwyn M Graham ◽

Aliza Werner-Seilder

Keyword(s):

Gender Differences ◽

Sleep Quality ◽

Sleep Disturbance ◽

Treatment Response ◽

Symptom Severity ◽

Burden Of Illness ◽

Night Time ◽

Insomnia Symptom ◽

Symptom Profiles ◽

Treatment Responsiveness

BACKGROUND Insomnia and sleep disturbance are pervasive and debilitating conditions affecting up to 40% of adolescents. Women and girls are at greater risk of insomnia, yet differences in treatment responsiveness between genders has not been investigated. Additionally, while women report greater symptom severity and burden of illness than men, this discrepancy is yet to be examined in adolescents. OBJECTIVE The purpose of the current study was to examine gender differences in sleep symptom profiles and treatment response in adolescents. METHODS Baseline insomnia symptom severity, sleep quality, sleep characteristics derived from sleep diaries and digital cognitive behavioural therapy for insomnia (CBT-I) treatment responsiveness were compared in boys and girls (aged 12-16 years) who participated in a pilot evaluation of the Sleep Ninja smartphone app. RESULTS We found that girls reported greater symptom severity (P=.04) and night-time wakefulness (P=.01 and .04) and reduced sleep duration (P=.02) and efficiency (P=.03), but not poorer sleep quality (P=.07), number of night-time awakenings (P=.16) nor time to get to sleep (P=.21), compared to boys. Treatment response to CBT-I was equivalent between boys and girls when comparing reductions in symptom severity and improvements in sleep quality (P=.70 and .06, respectively). CONCLUSIONS These results demonstrate the presence of gender differences in insomnia symptoms and severity in adolescents, and suggest further research is required to understand gender differences in insomnia symptom profiles to inform the development of gender-specific digital interventions delivered to adolescents.

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