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The Use of White Noise Machines to Improve Sleep in the Spinal Cord Injured Patient

Joshua R. Levin, DO (Sidney Kimmel Medical College At Thomas Jefferson University/TJUH PM&R Program, Philadelphia, Pennsylvania); Erin M. Kelly, DO

Meeting: AAPM&R Annual Assembly 2020

Categories: Quality Improvement (2020)

Session Information

Session Title: Virtual Poster Hall

Session Time: None. Available on demand.

Disclosures: Joshua R. Levin, DO: No financial relationships or conflicts of interest

Objective: The objective of this study was to improve the quality of sleep in patients with spinal cord injuries (SCI) admitted to acute rehab using white noise machines over a one-week period.

Design: We identified cognitively intact SCI patients over 18 years old admitted to acute rehab more than 48 hours with the complaint of insomnia who expressed interest in using a white noise machine. Setting : A model system spinal cord injury acute rehabilitation facility in Philadelphia, Pennsylvania. Participants : Ten SCI patients participated.

Interventions: Provided a white noise machine to interested SCI patients to improve sleep.

Main Outcome Measures: Six-question pre-utilization questionnaire, Insomnia Severity Index before and one week after machine use and a four-question questionnaire post-machine use.

Results: The most common factor contributing to insomnia was being awoken for medical reasons (n=4) and pain (n=4). Ninety percent had tried medications for sleep, most commonly melatonin. Medications helped 40% of patients. Pre-machine insomnia severity index ranged from 9-24 with a median of 15.7 (moderate severity). One patient was sent out emergently before using the machine. Of the remaining 9 patients, 77.7% reported sleep improved post-machine. Medication use decreased post-machine use, including one patient no longer requiring standing medication. The post-machine insomnia severity index scores ranged from 3-19 with a median of 11.5 (sub-threshold insomnia). Conclusions: The results of our study showed variable quantitative improvements in insomnia using the Insomnia Severity Index. However, there were other qualitative improvements noted in post-machine questionnaires with at least two patients expressing interest in purchasing a machine on discharge. White noise machines are a low-cost treatment of insomnia in the hospitalized patient. It would be of benefit to study their use in other hospitalized patients outside the SCI population in order to better assess the effectiveness of white noise machines more broadly.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Levin JR, Kelly EM. The Use of White Noise Machines to Improve Sleep in the Spinal Cord Injured Patient [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-use-of-white-noise-machines-to-improve-sleep-in-the-spinal-cord-injured-patient/. Accessed May 8, 2025.
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