Getting plenty of sleep is an essential part of nearly every patient's recovery plan, yet hospital settings are often too loud for that to happen, according to a recent report. A small 155-day study measured noise and sleep duration on an adult medical unit. The authors found that the average patient room noise levels (48 dB) universally exceeded the level recommended by the World Health Organization (30 dB) and that peak levels approached the level produced by a chain saw (80 dB). Noise levels were lower at night but still exceeded the recommended maximum level in every case and the recommended average levels in 94% of cases.

Figure. The "Yacker Tracker" at St. Joseph's Hospital Health Center in Syracuse, New York, monitors sound levels and dims overhead lights to remind staff to keep the noise down. Photo by Michelle Gabel /

More than 42% of the 92 patients with noise data reported noise-related disruptions of sleep. Actigraphy, which tracks body movement to determine sleep duration and efficiency (the ratio of sleep to time spent in bed), showed that patients got significantly less sleep in the hospital than they normally did, according to self-report (314 minutes versus 382 minutes), and that on more than half of the recorded nights, sleep efficiency was below the normal lower boundary of 80% recommended for adults; the mean level was also low, at 73.3%.

This is clinically significant sleep loss, the authors note, and much of the noise associated with it comes from preventable sources. The sources of disruptive noise most commonly reported were staff conversations (65%), roommates (54%), alarms (42%), intercoms (39%), and pagers (38%). "Hospitals should implement interventions to reduce nighttime noise levels in an effort to improve patient sleep, which may also improve patient satisfaction and health outcomes," the authors write.

Reducing noise may be a simple matter of adopting more careful habits, says Vineet Arora, associate professor of medicine at the University of Chicago's Pritzker School of Medicine and one of the study's authors. He recommends that nurses inquire about a patient's sleep hygiene and habits, ensure that doors are closed and lights are off, and batch tasks when possible to limit interruptions.-Laura Wallis

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