The Sounds and Sleeplessness in the ICU--Part I

Being in the ICU is hard enough to endure. Throw in sleeplessness caused by noise pollution and just about everything worsens.
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Noise. Whether it's the blare of traffic and the hustling sounds of a city, or just your neighbor's barking dog and lawn mower cutting into your Sunday snooze, noise pollution is something we all have to deal with to some degree. But what about indoor disturbances -- in a hospital when you're lying in the Intensive Care Unit?

I know, it's not something we think about much, which is partly why there hasn't been extensive investigations into this arena. But a fresh study out of the U.K. sheds some fascinating light on this subject.

As we all can attest from experience, noises can disturb sleep and make for rude awakenings when your body is trying to cycle through its motions to refresh and rejuvenate itself. But for people under compromised health conditions and enduring recoveries in ICUs, noises and their resulting sleep interruptions can be especially problematic. And most aren't in a position to complain or tell people in the room to tone it down.

Most case studies show that the noise levels in hospitals are much higher than established guidelines, and the very nature of ICUs in particular make for off-the-charts excessive noise levels. How does this all affect a sleeping patient? Significantly. Here are just a few consequences highlighted by the recent study:
  • Deeper delirium: -- the state of mind typical of those suffering through a trauma or fever and who experience restlessness, illusions, and incoherent thoughts and speech. No doubt any drugs a patient will be on can make this state worse, but so can poor sleep brought on by something as simple as too much ambient noise. Delirium not only increases a person's length of stay in a hospital, but also the severity of their condition.

  • Irregular circadian rhythms: ICU patients don't usually keep their normal sleep-wake patterns. Their physical condition can have them sleeping on and off during the day and night. Add to that intermittent loud noise and you've got a recipe for more erratic sleep patterns.
  • Post-traumatic stress disorder: Not all patients experience post-traumatic stress disorder after a stay in the ICU, but for those who don't get the sleep they need to recover quickly and stave off episodes of delusional memories, the risk for post-traumatic stress disorder rises considerably.
  • Lowered immune function: Just two days of sleep deprivation has been shown to impair the immune system. So imagine what this means for patients in need of their immune system the most at times like these.
  • Cardiovascular and respiratory effects: Studies have shown how noises can lower the function of these critical systems, causing a speed-up of the heart and negatively dampening respiratory performance.
  • Being in the ICU is hard enough to endure. Throw in sleeplessness caused by noise pollution and just about everything worsens. Sleep is essential in the recovery from illness or injury. Of all the places that should shelter sleep, the ICU has to be close to the top of the list.

    So what can we do about all this? I'll get to that in my next post, when I cover the study's examination of noise-reduction techniques in Part II. Do they work? And can you try them in your home?

    Sweet Dreams,

    Sweet Dreams,

    Michael J. Breus, PhD, FAASM

    The Sleep Doctor

    This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.