The impact of alarm sounds on patient sleep in the intensive care unit: A scoping review

INTRODUCTION: Disruption of sleep and circadian rhythms is highly prevalent in intensive care unit (ICU) patients and may be exacerbated by environmental noise. The specific impact of alarm sounds on patients' sleep and circadian rhythms in the ICU remains unclear. The aim of this scoping review was to systematically map the existing evidence on the impact of alarm sounds on sleep and circadian rhythms in ICU patients. METHODS: A systematic literature search across four databases (PubMed, Embase, Web of Science, CINAHL and Ovid Emcare) was conducted to identify studies examining the impact of alarm sounds on sleep and circadian rhythms in ICU patients. Data on study population, methodology, and main findings on alarm sound impact were extracted, summarized in tables, and narratively synthesized. RESULTS: The search yielded 429 unique publications, of which 24 met the inclusion criteria. Across studies, alarm sounds were consistently identified as a major source of sleep disruption, with 52% to 91% of ICU patients rating alarms as highly disturbing. Objective measures, though limited by small sample sizes, confirmed the significant role of alarms in disturbing sleep, often linking alarm sounds to arousals and awakenings, particularly at higher sound levels. No studies were identified that assessed effects on circadian rhythms or the impact of alarm management strategies. CONCLUSION: These findings underscore the substantial burden of alarm noise on ICU sleep, and highlight the lack of evidence regarding effects on circadian rhythms, as well as the need for effective alarm management strategies.