Written by Heather Johnson, RN
Resource Nurse, Empira
You may remember in our last post was our very own Heather Johnson’s podcast debut where she discussed the top 10 sleep disturbances. Now we would like to go into each disturbance with a little more detail.
Have you ever just fallen into a deep sleep, only to be awakened suddenly from the obnoxious noise of your furnace kicking on, or a dog barking in middle of the night? You are not alone.
In 2011, Empira started a 3 year restorative sleep quality improvement (PIPP) grant through the MN Department of Human Services. In the research for the grant, noise was identified as the number one sleep disturbance. Most of the research was conducted in congregate living situations (hospitals and long-term care communities) but there remains additional value in learning about how noise can disrupt anyone’s restorative sleep. In a 2012 National Sleep Foundation bedroom poll, 74% of Americans report that a quiet room as very important to getting a good night’s sleep.
The Cambridge Dictionary defines noise as the “Unnecessary information or activity, especially when it is unwanted, unpleasant, or loud.” The origin is from the word nausea and synonyms include: clamor, racket, uproar, commotion, pandemonium, and babble. By definition noise is not a pleasant word.
How does noise impact our sleep?
After sleeping 7-9 hours at night, have you awoken only to feel groggy and unrested? Noise may have played a factor. Sounds during the night have the ability to awaken and alert our brains, causing small night-time awakenings; ones that we may not recall, but that certainly impact the sleep quality we receive. Our brains continue to process sounds, even well into our sleep cycles and stages. Noise, especially when above 30-40 dBs, can cause us to experience wakefulness, to move and shift in bed, and to increase or change our heart rate and blood pressure. These small awakenings from noise may not even be something that you remember when you wake, but they definitely “rob” from your sleep quality (National Sleep Foundation.org, 2018).
We each have the ability to determine whether or not a certain sound is bothersome in our sleep and one that will wake you, based upon whether that particular sound has personal meaning to you. We awaken, and at times ever so slightly, to sound when it is relevant to us and if there is emotion tied to the sound. For example, you may sleep soundly through the noise of a toilet flushing, or the snoring of your bedmate. Yet, if your child is making a noise (moving in their crib or crying), you are more apt to waken because of the emotions you have tied to that particular noise.
In long-term care settings, we identified that noise from personal alarms and noise from staff conversations, especially during shift changes, were the most bothersome to the residents in our communities. As a result, we continued to encourage our communities to become alarm free and how best to tackle the noise coming from staff conversations. At this writing, all of our communities are alarm free.
To address staff conversations levels, we audited our communities using sound-bar readings that recorded the dB readings. This allowed us to report the findings to the members of the team that had worked to help identify the contributing causes. Once we determined the cause, the solutions became apparent.
What can you do about noise?
- Be mindful of the need for a quiet environment to accommodate restorative sleep and encourage others to do the same. Be respectful of designated “quiet times.”
- Identify and be aware of high noise times by asking residents and team members. Ask residents “Are there noises that are bothersome or awaken you during the night?” Begin auditing.
- Use a white noise machine to help block unwanted noise such as sounds from others that are still awake, the occasional sounds of the furnace kicking on or off, the neighbor’s dog, or the sounds of a roommate).
- Use ear plugs during sleep to help block out the sound of heavy traffic or passing trains.
Additionally, the National Sleep Foundation recognizes that sounds that we are hearing as we fall asleep are ones that should stay with you until you wake in the morning. What does this mean? If you are a person who needs to fall asleep to noise, the hum of a fan, or white noise are well preferred over the sounds of a television or radio. The fan and white noise machine offer a constant and continual sound that buffers and masks unwanted noise. White noise will not interfere with alerting the brain, whereas the sound coming from television or the voices and music for your radio offer various levels of noise, tone and volume.
Recent studies suggest that exposure to disruptive noise during the night, not only impacts our overall sleep quality, but exposure to night-time noise is likely associated with cardiovascular disease and stroke in the elderly (Hume, Kl, 2012). The World Health Organization stresses the importance of creating a noise free environment to promote restorative sleep at night, noting that there is an identifiable link to noise and personal overall health and well-being.
Cambridge English Dictionary. Retrieved from: https://dictionary.cambridge.org on June 18,2018.
Evidence-Based Design Meets Evidence-Based Medicine: The sound sleep study. The Center for Health Design Research Coalition. Harvard Medical School, 2010. Retrieved from: https://www.healthdesign.org/sites/default/files/Validating%%20Acustic%20Guidelines%20for%20HC%20Facilities_Sound%20Sleep%20Study.pdf
Hume, KL. (2012). Effects of environmental noise on sleep. Noise Health. Nov.-Dec; 14(61):297-302. Doi:10.4103/1463-1741.104897.