Practicing in an Emergency Department gives any Emergency Physician a different perspective on many facets of life. We operate on the borders of life and death 24 hours a day, 7 days a week, 365 days a year. However this constant commitment to our patients does not come without a price. For many of us, our careers in Emergency Medicine have some negative effect on our personal wellness and a common area that suffers is our sleep. Because of our shift work, our sleep schedule is constant changing and forcing us to sleep during times when we are habitually and biochemically not used to sleeping. While some of us can come home after an overnight shift and sleep for 12 hours next to a construction zone without difficulty, others have difficulty staying asleep for 45 minutes. Considering the importance of our time and our sleep, we cannot afford to not maximize the quality of our sleep.

If you fall into the category of those who have a difficult time sleeping, consider the effects of sound on your sleep. According to the National Sleep Foundation, sound can have a positive and/or negative impact on your sleep depending on multiple factors.

How Sound Can Negatively Affect Your Sleep:

• Your brain continuously registers and processes sound while you sleep.
• "Peak sounds" like door slamming, intermittent talking, sirens, etc. can disrupt your sleep depending on what stage of sleep you are in. Other common examples of peak noises include all noises from living in a city or busy neighborhood, a loud neighborhood dog, birds chirping, etc.
• Noises can cause you to move, shift between sleep stages, have changes in your heart rate or blood pressure, or wake you up.
• Inuitively, noises are more likely to wake you up from Stage 1 and 2 of sleep (light sleep) than from Stage 3 and 4. Also, noises are more disruptive during the second half of night.
• Individuals are different in their sensitivity to noise, meaning there really are "sound sleepers" and "light sleepers."
• There is also evidence to suggest that sounds with personal meaning (i.e. baby crying) are more likely to wake you up from sleep than sounds that have less meaning (i.e. snoring).
• Sleep disruption from noise goes beyond just cutting into your sleep and contributing to drowsiness. There is also evidence to suggest that long-term sleep disruption from noise is associated with hypertension.

How Sound Can Positively Affect Your Sleep:

• White noise creates a constant, ambient sound that can prevent "peak noises" from disrupting your sleep.
• White noise works by reducing the difference between the ambient background noise and the noise level of a peak noise.
• Evidence Based: In a study of patients in the ICU, white noise increased the threshold of peak noises to disrupt patient's sleep.
• Effective white noise can be achieved by multiple different ways including a sound machine, fan, air purifier. There are even apps for your smartphones that can generate background white noise.
• Experimenting with different volumes and types of white noise is suggested.
• Television is NOT the answer. You want an continuous, unchanging backgroun noise throughout the whole night. Television showsare constantly changing tone and volume. Also, there is the added, negative effects of light production. The National Sleep Foundation recommends turning the TV off before you start your sleep routine.

Don't forget to make your alarm louder than the background, white noise!

Top-Rated Sound Machines on Amazon.com

1. Marpac Dohm White Noise Sound Machine, avg. $49.95
2. Lectrofan White Noise Mechaine, avg $49.95
3. myBaby SoundSpa, avg $19.99
4. Sleep Easy Sound Conditioner, avg $24.99
5. Sound Machine by Silverflye, avg $24.99

Top Sound Machines Smartphone Apps

• Awoken, Free. (Android)
• Deep Sleep with Andrew Johnson, Free (iPhone, Android)
• DigiPill, Free. (iPhone, Android)
• Nature Sounds Relax and Sleep, Free. (Android)
• Pzizz Sleep, Free (iPhone)
• Relax and Sleep by Glenn Harrold, Free (iPhone, Android)
• Relax Melodies, Free (iPhone, Android)
• Sleep, $1.99 (iPhone)
• Sleep, Free (Android)
• Sleep Cycle, $1.99 (iPhone, Android)
• Sleep Genius, $4.99 (iPhone)
• Sleep Time+, $1.99 (iPhone, Android)
• Sleep Well Hypnosis, Free (iPhone, Android)
• Sleepmaker Rain, Free (iPhone, Android)
• White Noise, $1.99 (Android)

References:

1. Hear: Sound and Sleep. National Sleep Foundation. 2016.
2. Stanchina et al. "The influence of white noise on sleep in subjects exposed to ICU noise." Sleep Medicine. September 2005. Vol 6, Issue 5, Pp 423-28.
3. Goldman, Rena. The Best Insomnia Apps of 2016. Healthline.com. July 2016.

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