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The Sleep in the Intensive Care Unit: Lowering Elements of Noise in the Critical Care Environment (SILENCE) research programme was funded by a feasibility study grant awarded by the NIHR Research for Patient Benefit scheme, and was sponsored by the University of Oxford. The project ended in 2018 and results from the study have been published. See link below.

Intensive care © Chaikom/Shutterstock


Sound levels in the ICU are well above the recommended levels suggested by the World Health Organisation (WHO). Lowering these levels, even modestly, may help patients to sleep, and may result in fewer episodes of ICU-acquired delirium experienced by patients during their stay. Patients who develop delirium tend to have longer hospital stays and often have long-term health problems after they have been discharged home.

The NIHR funded SILENCE programme was a series of studies designed to lower noise levels, improve sleep hygiene, and ultimately reduce the incidence of ICU-acquired delirium.

The team reviewed transcripts from narrative interviews conducted with patients and their relatives with experience of the ICU. From these transcripts and companion ethnography sessions the SILENCE team identified some key areas of noise generation that could be addressed through targeted intervention. The team also organised an 'experience-based co-design' event. This meeting of medical and nursing staff, patients, and members of the research team resulted in a multi-faceted environmental intervention to reduce noise levels in the ICU.

Some simple environmental changes were implemented, a new training module was designed, and the team worked closely with the Institute of Sound and Vibration Research, University of Southampton to design and install a new noise monitoring system. 

Alongside the noise reduction work, the SILENCE project also set out to evaluate methods of sleep measurement in the ICU. 

For more information please see the publications from the project.