Sound and light levels in intensive care units in a large urban hospital in the United States

ABSTRACT

Intensive care units (ICUs) may disrupt sleep. Quantitative ICU studies of concurrent and continuous sound and light levels and timings remain sparse in part due to the lack of ICU equipment that monitors sound and light. Here, we describe sound and light levels across three adult ICUs in a large urban United States tertiary care hospital using a novel sensor. The novel sound and light sensor is composed of a Gravity Sound Level Meter for sound level measurements and an Adafruit TSL2561 digital luminosity sensor for light levels. Sound and light levels were continuously monitored in the room of 136 patients (mean age = 67.0 (8.7) years, 44.9% female) enrolled in the Investigation of Sleep in the Intensive Care Unit study (ICU-SLEEP; Clinicaltrials.gov: #NCT03355053), at the Massachusetts General Hospital. The hours of available sound and light data ranged from 24.0 to 72.2 hours. Average sound and light levels oscillated throughout the day and night. On average, the loudest hour was 17:00 and the quietest hour was 02:00. Average light levels were brightest at 09:00 and dimmest at 04:00. For all participants, average nightly sound levels exceeded the WHO guideline of < 35 decibels. Similarly, mean nightly light levels varied across participants (minimum: 1.00 lux, maximum: 577.05 lux). Sound and light events were more frequent between 08:00 and 20:00 than between 20:00 and 08:00 and were largely similar on weekdays and weekend days. Peaks in distinct alarm frequencies (Alarm 1) occurred at 01:00, 06:00, and at 20:00. Alarms at other frequencies (Alarm 2) were relatively consistent throughout the day and night, with a small peak at 20:00. In conclusion, we present a sound and light data collection method and results from a cohort of critically ill patients, demonstrating excess sound and light levels across multiple ICUs in a large tertiary care hospital in the United States. ClinicalTrials.gov, #NCT03355053. Registered 28 November 2017, https://clinicaltrials.gov/ct2/show/NCT03355053.

KEYWORDS:

• Intensive care units
• sound
• light
• devices
• critical illness
• urban hospitals

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Acknowledgments

We thank the participants for their contribution to this work.

Authors’ contributions

The authors’ contributions were as follows: MJL, BC, RAT, SQ, OJA, SSC, RJT, and MBW: designed the study; MJL, HSD, BC, RAT, SQ, AAB, NA, PVK, WMT, AH, SR, EP, JH, MAA, WG, LP, SSC, TTH, TT, OJA, RS, SSC, RJT, and MBW conducted research and contributed to statistical analyses; MJL, HSD, BC, RAT, SQ, AAB, NA, SSC, RJT, and MBW interpreted data; MJL, HSD, BC, RAT, SQ, and MBW wrote the manuscript; and all authors: read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are available from the Mass General Brigham Human Research Office/Institutional Review Board at Mass General Brigham (contact located at https://www.partners.org/Medical-Research/Support-Offices/Human-Research-Committee-IRB/Default.aspx) for researchers who meet the criteria for access to confidential data.

Ethics approval and consent to participate

All recruited patients provided written consent upon enrollment. The present study protocol was approved by the MGB Institutional Review Board #2017P000090.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07420528.2023.2207647.

Additional information

Funding

Research reported in this publication was supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under award number R01NS102190. This work was also supported by National Institute of Health [grant K99HL153795 to HSD].