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Published on: July 1, 2015
Assessment of a hearing protection device on infant sleep in the neonatal intensive care unit
Elisabeth Bloch-Salisbury1,2, Lauren McKenna2, Emma Boland2
1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Insights
A novel hearing protection device, DREAMIES®, significantly increased sleep duration in premature infants within the neonatal intensive care unit (NICU). This intervention may improve sleep quality and recovery for vulnerable newborns exposed to disruptive noise.
Area of Science:
- Neonatal care
- Sleep medicine
- Bioacoustics
Background:
- Premature infants in neonatal intensive care units (NICUs) face prolonged hospital stays.
- Exposure to adverse noise in the NICU can disrupt infant sleep, negatively impacting recovery and development.
- Effective strategies are needed to mitigate noise disturbances and support optimal sleep in premature neonates.
Purpose of the Study:
- To evaluate the impact of a novel circumaural hearing protection device (DREAMIES®) on the sleep patterns of premature infants.
- To compare sleep metrics using polysomnography (PSG) with the device on versus off.
- To assess the potential of DREAMIES® to improve sleep quality in a noisy NICU environment.
Main Methods:
- A single-session trial involving 10 premature infants (mean gestational age 34.1 weeks) in a Level III NICU.
- Polysomnography (PSG) was used to record and score sleep stages (Quiet Sleep, Active Sleep, Indeterminate Sleep, Wake) over three interfeed periods.
- Infants experienced conditions in a fixed order: DREAMIES® OFF1, ON, and OFF2, with a blinded rater scoring the PSG data.
Main Results:
- A statistically significant increase in total sleep duration was observed when DREAMIES® was ON compared to the initial OFF period (14.1% increase, p=0.05).
- Sleep duration decreased significantly when the device was turned OFF again (18.4% decrease, p=0.02), with a corresponding increase in wakefulness.
- The device showed a significant main effect on active sleep, with higher percentages observed when the device was ON.
Conclusions:
- The DREAMIES® hearing protection device demonstrates a potential to augment sleep in premature infants by mitigating the effects of adverse NICU noise.
- Findings suggest that reducing acute noise exposure can positively influence sleep architecture and duration in this vulnerable population.
- Further research is warranted to confirm these findings and explore the long-term developmental benefits of improved sleep in NICU infants.
Abstract:
Premature infants often require prolonged hospitalisation in the neonatal intensive care unit (NICU) where they are exposed to adverse noise that may disrupt sleep and further compromise recovery and developmental outcomes. This single-session trial assessed the effects of a novel circumaural hearing protection device (DREAMIES®; NEATCAP Medical LLC) on sleep in 10 premature infants (mean 34.1 weeks GA) in a Level III NICU. Using polysomnography (PSG), the infant's sleep was compared between three interfeed periods throughout which DREAMIES® was ON or OFF. Each infant received the same condition order, OFF1-ON-OFF2. The PSG 30 s epochs were scored by a rater masked to the condition as Quiet Sleep, Active Sleep, Indeterminate Sleep, and Wake. There was a 14.1% increase in sleep from OFF1 to ON (p = 0.05) and an 18.4% decrease in sleep from ON to OFF2 (p = 0.02); an analogous inverse effect was observed for wake (χ2 = 5.03, p = 0.08). There was a main effect of DREAMIES on active sleep (χ2 = 7.4, p = 0.025) due to more active sleep for ON1 (46%) compared with OFF2 (32%; p = 0.074). No significant effect was observed for quiet sleep or indeterminate sleep. On average, the sound level was 51 dBA (range 36-113 dBA) and did not differ significantly among the three periods. The strongest relationship between the minute-by-minute maximum sound level and movement actigraphy was observed for the OFF1 condition (ρ0.301, p < 0.001). These findings suggest that DREAMIES® may augment sleep in premature infants by reducing acute episodes of adverse noise in the NICU.
