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Noisy, sleepless hospitals (and how to rest in them – 1/25/12)

January 25, 2012

When You’re Ill You Really Need Rest

Rest is as necessary to life as food. Without it the body does not restore and regenerate.
Hospitals don’t seem to fully understand that connection.
A new study of noise in hospital rooms, published in the Archives of Internal Medicine, was not good news. The average hospital room ran about 50 decibels during the day – much more than the suggested 30. Alarms and intercoms sometimes can blast noise levels up to 80dB.
Try sleeping when it’s 80 dB in your room. No wonder hospital patients claimed to sleep an hour less in hospital than while ill at home.

Noise and Health
Humans pay vast attention to all our senses, generally first visual and next aural information. What we hear goes all over the brain.
Even if we don’t pay conscious attention to it.
Our world is noisy in a way unknown to our ancestors. Normally we could hear the sound of air – now it’s hard to hear our cell phone.
In previous generations doctors worried about how rock concerts increased deafness. Indeed, hearing loss is occurring early. Many in their fifties and sixties cannot hear well.
And what of today’s youth with ears hooked into iPods producing vigorous, chromatically dense stereo? Not to mention our streets and homes filled with the noise of leaf blowers?
We should expect that deafness will come early to many. The potential results in terms of depression, anxiety, and disillusionment have not been toted up. Yet as people like Harvard researcher Jo Solet have explained, the costs will be enormous. Now consider a particularly vulnerable group – the ill. What do patients want in a hospital bed?
Calm. Quiet. A restful place to recover.

Instead, especially in an ICU, you get the equivalent of treading the tracks at Grand Central Station.
Beyond the noise of IV machines and beeping sensors, the sweeping sounds from the hallways, alarms and intercoms, patients are frequently interrupted during sleep for “monitoring.”
Blood pressure and heart rate can be taken by machine. Yet many a patient wakens from deeply desired REM sleep at 4:30 or 5 AM to have their blood drawn. Or gets sent down for an imaging study that perhaps may start in two or three hours.

Rest and Recovery
How can people fully recover in such noisy hospital beds?
The answer: Slowly and fitfully – less effectively than they should.
Lack of sleep is related to higher rates of infection; ineffective immunity; more coronary artery disease; greater insulin resistance.
Could the high glucose readings in hospitals be related simply to lack of sleep in rest interrupted patients? Perhaps more than is surmised. Chronically sleep less than five hours and diabetes rates more than double.
So what is to be done?

Protect Yourself
There are many options for patients coming into a hospital who know that sleep is required for their recovery – and that pain, uncertainty, discomfort and bizarre hospital schedules will make that difficult at best:
1. Bring noise cancelling headphones, or regular headphones or ear plugs.
2. Carry with you an eyemask for sleep. Light often leaks into hospital rooms, even in the dead of night.
3. If you can bring in favorite books or just books that are calming, optimistic and soothing – which can then double as sleep aids.
4. Prepare to catnap in the afternoons – you have to sleep sometime.

Other Remedies
Humans are meant to sleep in the afternoons, even if we rarely do so these days.
The hours between 1 and 4 PM should be designated nap times in hospital wards.
Some medical actions will need to be done immediately – yet not everything.
Letting people sleep in the normal afternoon nap slot of the human body clock can help them recover from the sleep lost at night.
Similarly, the hours between midnight and 5 AM should be considered sleep times in most wards.
Many wards indeed try to make such hours longer – from around 11 PM to 6 AM.
But with nurses and doctors treating charts preferentially to people, often the early morning hours are not treated as true sleep times. There is too much noise about.
Music may sooth the savage beast, but noise can wake the moribund.
Patients need peace. Night-time should be quiet indeed.
Everybody needs to sleep – especially the ill. When ill you need more time to rest and recover – and sleep.
Rest, sleep, Sarasota Sleep Doctor, well-being, regeneration, longevity, body clocks, insomnia, sleep disorders, the rest doctor, matthew edlund, the power of rest, the body clock, psychology today, huffington post, redbook, longboat key news

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