1221 White Noise Implementation to Improve Sleep in Inpatient Acute Rehabilitation Unit

Abstract Introduction Hospitalized patients have lower sleep quality, lower total sleep time, high wake after sleep onset, frequent nocturnal awakenings and do not achieve the recommended duration of sleep. White noise is a constant, ambient sound that can improve sleeep quality and reduce sleep fragmentation. We aim to determine whether administration of white noise can improve patient sleep in an inpatient acute rehabilitation unit. Methods Patients were offered white noise machines in an acute rehabilitation unit at a Veteran’s Administration hospital. Patient questionnaires evaluated subjective perception of sleep quality. Nursing staff documented hourly logs where they visually evaluated whether patients appeared to be asleep. In the morning, physical medicine physicians documented patients’ rest quality and sleep medications received. Results 34 patients (32 males, 2 females) were evaluated with 160 patient-nights of reported data. 22 white noise machines were distributed. 47% of participants held a prior sleep diagnosis. 67% of patients who used white noise found it to be helpful. Patient perceived hours of sleep aligned with nurse observation logs overall with a trend towards all patients overestimating their sleep (5.9 hours vs. 6.63 hours, p-value 0.06). 81% of white noise users were satisfied with their sleep compared to 65% of the non-white noise group (p-value 0.17). There were no differences in nocturnal awakenings or daytime energy level between the groups. Finally, there were no statistical differences in the administration of PRN sleep medications (32% vs. 22%, p-value 0.28). Conclusion This quality improvement project found that white noise usage was feasible and well-received by patients. Overall, patients found the white noise to be helpful and there was a trend towards improved sleep satisfaction and reduced sleep medication use among white noise users but no statistically significant differences in perceived hours of sleep, nocturnal awakenings, or provider perceptions of energy level the following morning between users and non-users in this small study. Larger studies of white noise with quantitative measures of sleep can evaluate if this accessible treatment can improve inpatient sleep and reduce the use of sedative hypnotics. Support (if any)