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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2017

Open Access 01-12-2017 | Research

Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels

Authors: Maxime Elbaz, Damien Léger, Fabien Sauvet, Benoit Champigneulle, Stéphane Rio, Mélanie Strauss, Mounir Chennaoui, Christian Guilleminault, Jean Paul Mira

Published in: Annals of Intensive Care | Issue 1/2017

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Abstract

Background

It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain unclear. The aim of this study was therefore to evaluate carefully the impact of ICU sound intensity levels and their sources on ICU patients’ sleep over a 24-h period.

Methods

Sleep and sound levels were recorded in 11 ICU intubated patients who met the criteria. Sleep was recorded using a miniaturized multi-channel ambulatory recording device. Sound intensity levels and their sources were recorded with the Nox-T3 monitor. A 30-s epoch-by-epoch analysis of sleep stages and sound data was carried out. Multinomial and binomial logistic regressions were used to associate sleep stages, wakefulness and sleep–wake transitions with sound levels and their sources.

Results

The subjects slept a median of 502.2 [283.2–718.9] min per 24 h; 356.9 [188.6–590.9] min at night (22.00–08.00) and 168.5 [142.5–243.3] during daytime (8 am–10 pm). Median sound intensity level reached 70.2 [65.1–80.3] dBC at night. Sound thresholds leading to disturbed sleep were 63 dBC during the day and 59 dBC during the night. With levels above 77 dBC, the incidence of arousals (OR 3.9, 95% CI 3.0–5.0) and sleep-to-wake transitions (OR 7.6, 95% CI 4.1–14) increased. The most disturbing noises sources were monitor alarms (OR 4.5, 95% CI 3.5–5.6) and ventilator alarms (OR 4.2, 95% CI 2.9–6.1).

Conclusions

We have shown, in a small group of 11 non-severe ICU patients, that sound level intensity, a major disturbance factor of sleep continuity, should be strictly controlled on a 24-h profile.
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Metadata
Title
Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels
Authors
Maxime Elbaz
Damien Léger
Fabien Sauvet
Benoit Champigneulle
Stéphane Rio
Mélanie Strauss
Mounir Chennaoui
Christian Guilleminault
Jean Paul Mira
Publication date
01-12-2017
Publisher
Springer Paris
Published in
Annals of Intensive Care / Issue 1/2017
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-017-0248-7

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