Sleep Disruption due to Hospital Noises A Prospective Evaluation
Sleep Disruption due to Hospital Noises A Prospective Evaluation
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DOI：
10.7326/0003-4819-156-12-201208070-00472
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发表时间：
2012-08-07
影响因子：
39.2
通讯作者：
Solet, Jo M.
中科院分区：
文献类型：
--
作者：
Buxton, Orfeu M.;Ellenbogen, Jeffrey M.;Solet, Jo M.
背景：睡眠对于维持健康和福祉起着至关重要的作用；然而，住院的患者经常暴露在可能扰乱睡眠的噪音中。由于声音与睡眠生理学之间相互作用的信息不完整，削弱医院噪音的努力受到限制。目的：通过按声音级别、类型和睡眠阶段检查睡眠期间对典型医院噪音的皮质（脑电图）唤醒反应，确定睡眠的声音干扰情况。设计：为期 3 天的多导睡眠图研究。地点：声音衰减睡眠实验室。参与者：志愿者样本 12 名健康参与者。干预：基线（假）晚上，然后是 2 个干预晚上，受控地呈现医院常见的 14 种声音（例如语音、静脉注射警报、电话、制冰机、外部交通和直升机）。在特定睡眠阶段，声音以经过校准、逐渐增加的分贝水平（40 至 70 dBA [分贝，根据正常听力范围进行调整]）进行测量。测量：在快速眼动 (REM) 睡眠和非快速眼动 (NREM) 睡眠阶段 2 和 3 期间，使用既定标准进行脑电图唤醒。结果：声音呈现产生的唤醒响应曲线因声音级别、类型和睡眠阶段而异。电子声音比其他声音（包括人声）更能唤起人们的兴奋感，而且不同声音类型的反应存在很大差异。正如预期的那样，NREM 第 3 阶段的声音比 NREM 第 2 阶段的声音不太可能引起唤醒；出乎意料的是，与非快速眼动睡眠中出现的声音相比，快速眼动睡眠中出现的声音被唤醒的概率因声音类型而异，并导致瞬时心率更大、更持续地升高。 局限性：该研究仅包括 12 名参与者。这些健康人的结果可能低估了噪音对住院患者睡眠的影响。结论：睡眠期间的声音会影响大脑皮层活动和心血管功能。这项研究系统地量化了一系列医院声音对睡眠的破坏能力，提供了对于改善新建和现有医疗保健设施的声环境以实现最高质量的护理至关重要的证据。
Background: Sleep plays a critical role in maintaining health and well-being; however, patients who are hospitalized are frequently exposed to noise that can disrupt sleep. Efforts to attenuate hospital noise have been limited by incomplete information on the interaction between sounds and sleep physiology.Objective: To determine profiles of acoustic disruption of sleep by examining the cortical (encephalographic) arousal responses during sleep to typical hospital noises by sound level and type and sleep stage.Design: 3-day polysomnographic study.Setting: Sound-attenuated sleep laboratory.Participants: Volunteer sample of 12 healthy participants.Intervention: Baseline (sham) night followed by 2 intervention nights with controlled presentation of 14 sounds that are common in hospitals (for example, voice, intravenous alarm, phone, ice machine, outside traffic, and helicopter). The sounds were administered at calibrated, increasing decibel levels (40 to 70 dBA [decibels, adjusted for the range of normal hearing]) during specific sleep stages.Measurements: Encephalographic arousals, by using established criteria, during rapid eye movement (REM) sleep and non-REM (NREM) sleep stages 2 and 3.Results: Sound presentations yielded arousal response curves that varied because of sound level and type and sleep stage. Electronic sounds were more arousing than other sounds, including human voices, and there were large differences in responses by sound type. As expected, sounds in NREM stage 3 were less likely to cause arousals than sounds in NREM stage 2; unexpectedly, the probability of arousal to sounds presented in REM sleep varied less by sound type than when presented in NREM sleep and caused a greater and more sustained elevation of instantaneous heart rate.Limitations: The study included only 12 participants. Results for these healthy persons may underestimate the effects of noise on sleep in patients who are hospitalized.Conclusion: Sounds during sleep influence both cortical brain activity and cardiovascular function. This study systematically quantifies the disruptive capacity of a range of hospital sounds on sleep, providing evidence that is essential to improving the acoustic environments of new and existing health care facilities to enable the highest quality of care.