A new study published in the International Journal for Quality in Health Care reveals noise in hospital wards typically surpasses the levels set by the World Health Organization to significantly impact patient recovery by disturbing sleep.
The Silent Threat: Investigating Sleep Disturbances in Hospitalized Patients shows the average noise level in patient rooms is 47.2dB, which exceeds the World Health Organisation's recommendation of 30dB.
The study – a collaboration between researchers at Macquarie University's Australian Institute of Health Innovation (AIHI), St Vincent's Health Network, the University of New South Wales, and the Sleep Foundation, Australia – says 40 per cent of patients rate their hospital sleep experience as "poor" or "very poor" primarily due to noise.
Corey Adams, a Clinical Researcher at AIHI and lead author of the study, says while people know hospitals can be noisy places, the research found the problem is “more severe than expected.”
"Research shows patients sleep an average of five hours in hospital, which is considerably less than what they typically sleep at home," he says.
"Sleep in hospital is also interrupted and fragmented. Patients are disturbed by alarms, equipment, talking and clinical activities, which prevent them from reaching the deeper sleep essential to recovery and healing.
"Noise is ranked as 'very disruptive' by one in five patients surveyed for this study, followed by 'acute health conditions' and 'nursing interventions,' with patients in shared rooms reporting significantly higher levels of sleep disturbance than those in single rooms."
Sharing disrupts sound sleeping
Researchers collected sleep experience data by surveying patients who spent more than 24 hours in one of seven wards in a large public hospital in Sydney during four weeks in late 2021, while also placing noise measuring devices in single and shared rooms.
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Noise levels were monitored overnight across a 12-hour period from 8pm, with the average sound level sitting at 47.2dB. The maximum readings spiked between 93.6dB and 106.9dB, louder than a busy restaurant and almost as loud as a motorbike.
"The issue is worse in shared rooms. The majority of patients in shared rooms reported 'poor' or 'very poor' sleep with sound levels exceeding 100dB, which is equivalent to the noise from a lawn mower," Mr. Adams says.
"We also discovered the number of noise peaks in all shared rooms was very high and, for example, in one room there were 86 noise peaks during a 12-hour period. On average, this equates to one noise interruption every seven minutes."
Patients and staff both at risk
The study notes diminished sleep increases the risk of health complications like impaired glucose tolerance, hypertension, increased stress hormone response, and delirium.
Mr Adams explains a patient not getting quality sleep may feel more pain, suffer memory lapses, display a deteriorating mood, and become anxious or agitated.
"This may also affect hospital staff exposed to the same noise levels, with an impact on their concentration and memory," the patient wellbeing specialist says.
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"It’s accepted hospitals are noisy, but they need not be, and it's about challenging norms to reduce the impact on patients and staff. The good news is there are simple things we can do.
"We have developed the HUSH project – Help Us Support Healing – with patients given a pack on admission similar to what's provided on a plane, with earplugs, eye masks, and information on better sleeping in hospital.
“It was a small project that made a big difference to health and wellbeing, with research showing it was particularly helpful for patients in shared rooms.
“It's also about redefining care to create an environment that supports healing, and reducing the number of times staff visit a room by 'chunking' activities together can further minimise disturbance to patients.
“A lot of noise is generated by people talking, when we’re in an environment that’s noisy we increase our own noise, so breaking that cycle is key with awareness important to this.
"A quiet hospital isn’t a luxury, it’s a necessity. These efforts aren’t just improving people’s comfort, it’s about enhancing patient safety and promoting healing.”
Corey Adams, pictured above, is a clinical researcher at the Australian Institute of Health Innovation in the Faculty of Medicine, Health and Human Sciences, Macquarie University.
