The noisy hospital

Everyone knows that hospitals aren’t the best place to go for a good night’s sleep.

A study published this week in the Archives of Internal Medicine adds more proof with several new findings, including one that’s truly startling: The average noise level in patient rooms can reach 80 decibels – almost as loud as a chainsaw.

How about a little more peace and quiet, please?

Researchers at the University of Chicago Medical Center studied about 100 adult patients, tracking how well they slept in the hospital and how much noise they were exposed to.

Among the findings:

– Although hospital rooms were less noisy at night than during the day, they were far from quiet.

– The average nighttime noise level in inpatient rooms was around 50 decibels, which exceeds recommendations by the World Health Organization; 30 to 40 decibels is considered the maximum for a hospital setting.

– At times, noise levels spiked to 80 decibels. This is the equivalent of a chainsaw or the typical home stereo listening level. It’s louder than the noise of an average factory or office, a busy street or a small orchestra, and only a couple of notches below the noise level of heavy truck traffic.

– The noise came from many sources: staff conversations, roommates, alarms. The loudest source? Intercoms and pagers.

– The noisier the room, the less likely it was that the patient slept well. On average, patients exposed to the highest nighttime noise levels slept 76 minutes less than those exposed to the least amount of noise. Sleep quality for patients in the noisiest rooms also tended to be worse.

Dr. Vineet Arora, who led the study, told Reuters Health, “One of the most common complaints that patients will report is that they had a difficult night sleeping.” The risk is that it could hinder the patient’s recovery, she explained.

Sleep experts who reviewed the study say there could be additional factors to blame for sleep disruption in the hospital. Patients simply might not sleep as well when they’re sick, they suggested. Also, patients who are sicker often have more nurses coming in and out of the room to monitor them during the night, administer medications and so on.

There doesn’t seem to be a cheap or easy fix to the hospital noise problem. Long-lasting solutions often involve engineering, such as installing wall and floor coverings that absorb sound or ditching overhead intercoms in favor of wireless pagers.

Although I don’t advocate tearing down older hospitals and starting over, new construction does offer opportunities to incorporate better noise reduction strategies. When Rice Memorial Hospital here in Willmar built a new patient wing a few years ago, considerable attention was paid to creating an environment that would be healing for both patients and staff. For starters, all the patient rooms are now private. The layout is designed so that no patient room is directly opposite a nurse’s station or utility closet or other potentially noisy location. Corridors for staff use, carts, equipment and so on are separate from patient corridors. Overhead paging also was replaced with wireless communication. When I’ve visited friends and relatives hospitalized at Rice, one of the first things I usually notice is how quiet it is.

Unfortunately, many hospitalized patients will have to continue to put up with a certain amount of noise. For them, sleep experts have these suggestions: Ask staff to keep the room door closed. Wear noise-canceling headphones. Open the window blinds during the daytime to let in natural light and try to walk around the day if they’re physically able. Patients might not be able to change the environment but small changes can help make hospital noise levels less bothersome.

Photo: U.S. National Archives and Records Administration

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