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Children’s wards are too noisy at night

Noise levels exceed WHO recommendations and impact on sleep of children and their parents

Ingrid Torjesen

Tuesday, 24 July 2018

The noise on children’s medical wards at night exceeds the maximum limit recommended by the World Health Organization (WHO), and is significantly louder than in their bedrooms at home, a small comparative study*, published online in Archives of Disease in Childhood, has found.

The background noise on children’s wards may be contributing to shorter and poorer quality sleep during an inpatient stay, say the researchers.

Previous research has found that children’s cancer and intensive care wards are noisy at night, but it was unclear whether the same was true of general medical wards so researchers compared the length and quality of sleep experienced by 46 children and 16 of their mothers on general children’s wards at one large hospital and in their bedrooms at home.

Sleep-wake patterns were recorded using a tracking device (actigraph) worn on the wrist for around three nights in both of the locations, while decibel levels were monitored using a sound level meter at the child’s bedside in hospital and at home.

Sound level monitoring was completed for eight of the children at both locations for at least one night. The average sound level recorded on the hospital ward was 48.24 decibels, reaching 50.35 decibels for beds in open bays. This is higher than the WHO recommended average maximum for a hospital ward of 30 decibels, peaking at 45 decibels, and the background noise levels recorded in the children’s bedrooms of 34.7 decibels.

On average, the children slept for 63 fewer minutes a night, averaging a total of just under 7.5 hours, while in hospital than they did at home, and their mothers got just under 73 fewer minutes, averaging six hours 20 minutes. Sleep quality was also poorer when in hospital.

The researchers suggested that “it is reasonable to infer that noise will have affected sleep,” and highlighted a growing body of evidence suggesting that sleep has a role in regulating emotions and behaviour across the life course, and an impact on pain response and the immune system.

“Despite 150 years of medical progress we have forgotten the basic lessons of patient care,” they said which was exemplified by Florence Nightingale, who in 1859, wrote that: “unnecessary noise is the cruellest absence of care”.

*Bevan R, Grantham-Hill S, Bowen R, et al. Sleep quality and noise: comparisons between hospital and home settings. Arch Dis Child Epub ahead of print: July 2018. doi:10.1136/archdischild-2018-315168

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