www.noiseandhealth.

org

Sleep disturbance due to noise:

Current issues and future research
Ken Hume
Division of Health Science and Centre for Air Transport and the Environment, Manchester Metropolitan University, UK

Abstract
There is growing interest in carrying out further research to understand and reduce the impact of aircraft noise on
airport neighborhood in anticipation of the projected substantial increase in global aviation. Soundscapes provide new
analytical methods and a broader, more comprehensive appreciation of the aural environment, which may have a useful
role in understanding noise-induced sleep disturbance and annoyance. Current noise metrics like Leq do not provide
a common language to report noise environment to residents, which is a key obstacle to effective noise management
and acceptance. Non-auditory effects complicate the production of consistent dose-response functions for aircraft noise
affecting sleep and annoyance. There are various end-points that can be chosen to assess the degree of sleep disturbance,
which has detracted from the clarity of results that has been communicated to wider audiences. The World Health
Organization (WHO-Europe) has produced Night Noise Guidelines for Europe, which act as a clear guide for airports
and planners to work towards. Methodological inadequacies and the need for simpler techniques to record sleep will be
considered with the exciting potential to greatly increase cost-effective field data acquisition, which is needed for large
scale epidemiological studies
Keywords: Sleep disturbance, noise, aircraft noise, soundscapes
PubMed ID: ****

DOI: 10.4103/1463-1741.63206

Introduction
Sleep is a fundamental human behavior which is essential
for development, health and well-being. Sleep displays both
homeostatic and rhythmical features and its alternating pattern
with wake presents one of the most obvious and essential
human circadian rhythms. Sleep is a reversible process
which can be readily disturbed by noise to cause a full range
of disturbance from full awakening to minor unconscious
autonomic perturbations. This reversible nature of sleep due
to noise has provided an essential evolutionary advantage
where the auditory system, unlike the visual system, can still
monitor the environment and arouse the vulnerable sleeper
in response to potential danger. In present times, noisedisturbed sleep is a cause of considerable annoyance with
potential health and well being affects.
Noise pollution has been described as the modern unseen
plague. It is generally accepted that the developed and
developing countries are becoming noisier places. For
example, mobile phone ring tones have the ability to disturb
the most tranquil place at any time of day or night. Humans
are responsible for most of the noise that disturbs sleep in the
home, whether it is generated outside due to transportation
Noise & Health, April-June 2010, 12:47,70-6

noise or inside because of a loud snoring partner; both are

unwelcome.
Noise can have a number of unwanted effects. It reduces
the fidelity of communication, interferes with cognitive
processes and disturbs sleep, all of which can contribute
to cause annoyance and complaint. There are various
metrics and standards that have been modeled and applied
to environmental noise in an attempt to limit the problem
to an acceptable degree. Many research workers in the
field consider sleep disturbance due to environmental noise
to be the most detrimental to health. Most people would
consider the availability of an undisturbed nights sleep as
a fundamental right and a prerequisite for their continued
health and well-being.
The perceived problem of noise disturbance depends, to a
large part, on non acoustic factors. For example, the extent of
nuisance perceived by an individual depends on their relative
position along a utility perspective with regards to the noise
producer. An airport worker who lives near an airport may
well be affected by aircraft noise but s/he is far more likely
to accept this nuisance and cope with the stressor than a
neighbor who does not rely on the airport for their livelihood.
70

Hume: Noise induced sleep disturbance

This is an example of the many non-acoustical factors that

make the production of consistent dose-response curves
elusive in this general area. There are varying reports from
different countries on the most disturbing form of noise
pollution at night, for example, mopeds in The Netherlands,
but transportation noise at night is a major factor in most
reports. A reviewer[1] has echoed a frequent observation in
annoyance and complaint analysis that the psychological
dimension of the expressed annoyance is highly related to the
specific relationship that exists between the noise producer
and receiver, in essence, your neighbors dog barks louder
than your dog! It is evident that non-auditory factors (e.g.
relationship with the noise producer) play a significant part in
the subjective response to sound and noise and the degree of
disturbance or annoyance reported.
Noise is generally considered bad but is frequently a byproduct of well-accepted operations which are valued by
the community at large. For example, the traveler considers
rapid transportation as good while the resident near the
highway, train track or airport considers the noise a nuisance
i.e. bad. This is similar to many controversial issues in the
world today where there is a need for balance between the
potential damage that noise can cause in a neighborhood
and the benefits accrued by many people from the modern
transport systems. In such situations, the scientists need
to assess the point at which unacceptable harm is likely to
occur and provide suitable metrics which allow appropriate
regulation and management.
There is considerable current interest in carrying out
further research to understand and reduce the impact of
aircraft noise on airport neighborhood in anticipation of the
projected substantial increases in global aviation. There is a
realization that the standards and criteria applied to determine
environmental impact need updating because of the changes
that have occurred in aviation over the last few decades, such
as quieter aircraft but a greatly increased number of flights.
Also, awareness of environmental issues and the expectations
of a better quality of life seem to have risen in the general
public. The US Department of Transportation Federal
Aviation Administration (FAA) apply a level of 65 DNL
(LaMax.A) which is the point at which 25% of residents
on a composite curve were predicted to become extremely
annoyed by aircraft noise.[2] The cut-off point is arbitrary but
clear-cut and provides a level which is embedded in current
US legislation. However, the FAA is currently in the process
of developing a research program to review this standard and
its applicability for the future which scientifically informs
future policy to reduce the impact of aircraft noise.[3] The
European Union Directive 2002/49/EC (END) requires
member states to generate environmental noise maps which
are decibel/Leq-based, irrespective of the sound components
of this noise and whether they are considered annoying or
not. However, besides a requirement to generate action
plans from these noise maps, there is no practical guidance
71

provided for assessing and mitigating the potential effects of

traffic noise on sleep.
Part of the increase in global noise is due to continued growth
of a 24 hour culture in most developed countries which results
from both more activity and noise intrusion into the nighttime sleep period and more people trying to sleep during
the daytime (e.g. shift workers) when ambient noise levels
are higher. Not only is the environment becoming noisier
but it also seems, from some annoyance data, that our ears
are becoming bigger as we are becoming more sensitive
and annoyed at lower noise levels, particularly by aircraft
noise.[4] This effect has been attributed to increased affluence
and expectation of higher qualities of life and is more
noticeable where step changes in the noise source have
occurred, e.g. initial operation of a new runway.[5]
This brief review will consider some fundamental issues
concerning noise and sleep disturbance, consider the
continuing and emerging issues with some suggestions how
research may develop in the future, with an emphasis on
transportation noise and particularly aviation.

Sound Level and Soundscapes

There have been recent attempts to understand the cause
of noise disturbance better, the realization that it is not just
the noise level, as usually measured in decibels, but a more
complete analysis and description of the noise, in the way that
ones favorite music can be played at much higher sound levels
without apparent distress is required. This could involve new
analytical methodologies associated with soundscapes, which
provide a broader and more comprehensive appreciation of
the aural environment.[6]
It has been demonstrated that more rapid rise times in the
sound envelope for an aircraft noise event increases the
ability to awaken a sleeping subject[7] and /or induce a
movement arousal.[8] Sounds in which various fundamental
characteristics were altered (e.g. square waves, mixtures of
pure tones, white noise) have recently been shown[9] to have a
20 dB difference in their ability to awaken sleeping subjects.
The soundscape approach tries, in part, to provide a wider, more
comprehensive description of noise and sound. For example,
it can be seen how extremely limited it would be to describe
a piece of music just by sound level indicators. An example
of this shift to a more comprehensive description of noise is
seen in the recent European involvement in an International
COST project (2008) entitled Soundscape of European Cities
and Landscapes in which its main objective is stated as to
provide the underpinning science for soundscape research and
make the field go significantly beyond the current state-of-theart, through coordinated international and interdisciplinary
efforts. This well funded initiative accepts that reducing
sound level ... does not necessarily lead to improved quality of
Noise & Health, April-June 2010, Volume 12

Hume: Noise induced sleep disturbance

This is an example of the many non-acoustical factors that

make the production of consistent dose-response curves
elusive in this general area. There are varying reports from
different countries on the most disturbing form of noise
pollution at night, for example, mopeds in The Netherlands,
but transportation noise at night is a major factor in most
reports. A reviewer[1] has echoed a frequent observation in
annoyance and complaint analysis that the psychological
dimension of the expressed annoyance is highly related to the
specific relationship that exists between the noise producer
and receiver, in essence, your neighbors dog barks louder
than your dog! It is evident that non-auditory factors (e.g.
relationship with the noise producer) play a significant part in
the subjective response to sound and noise and the degree of
disturbance or annoyance reported.
Noise is generally considered bad but is frequently a byproduct of well-accepted operations which are valued by
the community at large. For example, the traveler considers
rapid transportation as good while the resident near the
highway, train track or airport considers the noise a nuisance
i.e. bad. This is similar to many controversial issues in the
world today where there is a need for balance between the
potential damage that noise can cause in a neighborhood
and the benefits accrued by many people from the modern
transport systems. In such situations, the scientists need
to assess the point at which unacceptable harm is likely to
occur and provide suitable metrics which allow appropriate
regulation and management.
There is considerable current interest in carrying out
further research to understand and reduce the impact of
aircraft noise on airport neighborhood in anticipation of the
projected substantial increases in global aviation. There is a
realization that the standards and criteria applied to determine
environmental impact need updating because of the changes
that have occurred in aviation over the last few decades, such
as quieter aircraft but a greatly increased number of flights.
Also, awareness of environmental issues and the expectations
of a better quality of life seem to have risen in the general
public. The US Department of Transportation Federal
Aviation Administration (FAA) apply a level of 65 DNL
(LaMax.A) which is the point at which 25% of residents
on a composite curve were predicted to become extremely
annoyed by aircraft noise.[2] The cut-off point is arbitrary but
clear-cut and provides a level which is embedded in current
US legislation. However, the FAA is currently in the process
of developing a research program to review this standard and
its applicability for the future which scientifically informs
future policy to reduce the impact of aircraft noise.[3] The
European Union Directive 2002/49/EC (END) requires
member states to generate environmental noise maps which
are decibel/Leq-based, irrespective of the sound components
of this noise and whether they are considered annoying or
not. However, besides a requirement to generate action
plans from these noise maps, there is no practical guidance
71

provided for assessing and mitigating the potential effects of

traffic noise on sleep.
Part of the increase in global noise is due to continued growth
of a 24 hour culture in most developed countries which results
from both more activity and noise intrusion into the nighttime sleep period and more people trying to sleep during
the daytime (e.g. shift workers) when ambient noise levels
are higher. Not only is the environment becoming noisier
but it also seems, from some annoyance data, that our ears
are becoming bigger as we are becoming more sensitive
and annoyed at lower noise levels, particularly by aircraft
noise.[4] This effect has been attributed to increased affluence
and expectation of higher qualities of life and is more
noticeable where step changes in the noise source have
occurred, e.g. initial operation of a new runway.[5]
This brief review will consider some fundamental issues
concerning noise and sleep disturbance, consider the
continuing and emerging issues with some suggestions how
research may develop in the future, with an emphasis on
transportation noise and particularly aviation.

Sound Level and Soundscapes

There have been recent attempts to understand the cause
of noise disturbance better, the realization that it is not just
the noise level, as usually measured in decibels, but a more
complete analysis and description of the noise, in the way that
ones favorite music can be played at much higher sound levels
without apparent distress is required. This could involve new
analytical methodologies associated with soundscapes, which
provide a broader and more comprehensive appreciation of
the aural environment.[6]
It has been demonstrated that more rapid rise times in the
sound envelope for an aircraft noise event increases the
ability to awaken a sleeping subject[7] and /or induce a
movement arousal.[8] Sounds in which various fundamental
characteristics were altered (e.g. square waves, mixtures of
pure tones, white noise) have recently been shown[9] to have a
20 dB difference in their ability to awaken sleeping subjects.
The soundscape approach tries, in part, to provide a wider, more
comprehensive description of noise and sound. For example,
it can be seen how extremely limited it would be to describe
a piece of music just by sound level indicators. An example
of this shift to a more comprehensive description of noise is
seen in the recent European involvement in an International
COST project (2008) entitled Soundscape of European Cities
and Landscapes in which its main objective is stated as to
provide the underpinning science for soundscape research and
make the field go significantly beyond the current state-of-theart, through coordinated international and interdisciplinary
efforts. This well funded initiative accepts that reducing
sound level ... does not necessarily lead to improved quality of
Noise & Health, April-June 2010, Volume 12

Hume: Noise induced sleep disturbance

life in urban/rural areas, and a new multidisciplinary approach

are essential. It indicates that the cooperation of a broader mix
of specialism including human and social sciences is needed
apart from physical measurement to fully understand the
effects of sounds.
There have been European initiatives to understand the
underlying community impact which involved investigating
how to make the sound of aircraft more pleasant, for example,
the recent EU-funded study SEFA (Sound Engineering
For Aircraft, 2003-07) in which aircraft noise producing
components were investigated for potential modification to
produce an overall aircraft sound which was not necessarily
quieter but produced a more acceptable sound signature
to the human ear. These techniques have been applied
successfully in the car industry, but this was primarily for the
benefit of the driver and passengers and not the community
and roadside pedestrians hearing the car pass-by. SEFA has
been recently followed by a closely related European project
COSMA (Community oriented solutions to minimize aircraft
noise annoyance, 2009-2012) which has as its ultimate goal
the design of aircraft and their operations for a minimum of
annoyance in the surrounding airport community.

Noise Metrics
A major cause of annoyance and complaint around large
noisy operators like airports seems to be due to the lack of
transparency and understanding between the way airports
and governmental organizations provide information on the
noisiness of an airport. Noise information is usually provided
in time period energy equivalent noise contours; for example,
Ln or DNL, which is a number of transpositions away from
what the residents actually hear and is not some averaged
cumulative noise metric but individual aircraft noise events.
Supplementary metrics in Australia[10] have made a positive
contribution to consultation exercises. There have been recent
studies in the UK[11] that highlighted these problems and the
benefits of clearer metrics which better reflect the residents
experience. For example, the number of minutes per day that
aircraft noise exceeds a noticeable level, like, N70.
In the UK study,[11] focus groups revealed that residents
were confused and distrusted energy equivalent metrics
such as Leq which are aggregations of individual aircraft
noise events (ANE). They favored disaggregation of key
elements i.e. time, frequency of flights and noise level; even
preferring bar charts for specific location sites and specific
information such as flight path densities overlaid onto noise
foot prints e.g. N70 and Leq. There was some appreciation
that the conventional Leq metric allows a legally defendable
basis for land planning and developmental decisions but
overall inhibits public scrutiny and understanding and does
not provide a common language for reporting the noise
environment, which is a key obstacle to effective noise
management and residents acceptance.
Noise & Health, April-June 2010, Volume 12

Noise and Sleep Disturbance

Sleep is the paramount restorative process necessary to
maintain normal levels of brain and behavioral functioning,
mood and well-being while awake. Sleep disturbance is
important because if it is sufficiently severe it reduces
our nightly recuperation, which then affects our waking
performance as well as our health and mood. There are limited
techniques available to measure the effect of sleep loss or
disruption on waking activities and they are cumbersome
and time consuming; for example, multiple sleep latency test
(MSLT) and vigilance tasks. More recently, there has been
interest in daytime studies that are more relevant and applied
which highlight previous nights sleep problems, like driving
error in simulators.
There is further complexity in sleep where noise can affect
the cardiovascular system without producing full arousal
i.e. awakening. Therefore, sleep disturbance is not a unitary
concept; there is a full range of effect from full blown
behavioral awakening signaled by the subject via a pushbutton, to subtle changes in autonomic physiology; these
changes are not necessarily consistent within an individual
for a given level of noise stimulus as there are complex
patterns of neurophysiology associated with the different
EEG-defined sleep stages and the time of night. In addition,
actigraphy, which measures limb movement has been used
as it is frequently associated with relatively major arousals in
the sleep EEG. Also, autonomic nervous system arousals like
heart rate accelerations, which can occur in response to noise
without major EEG arousals, have been used to gauge sleep
disturbance. Given this mix of techniques it is easy to see that
there are various end-points that can be chosen to assess the
degree of sleep disturbance. However, measures are extracted
from EEG based polysomnography, which is considered
the gold-standard of sleep recording and provides a direct
measure of cerebral activity from which a number of macro
and micro-structural features can be extracted.[12]
A number of reviewers have pointed out that this diversity of
end-points has detracted from the clarity of results that can
be communicated to wider audiences. In this short paper it
is impossible to fully review all the relevant work on sleep
disturbance due to noise and not necessary when adequate
longer reviews exist. However, it is possible to consider
the main important consensus findings and understand the
pressures operating, like political, social and economic;
based on current evidence, useful suggestion and pointers can
be made for the future.
A major development over the last five years in this
field has been the full publication of the largest and most
comprehensive study carried out by Alex Samel and Mathias
Basner and co-workers at the DLR-Institute of Aerospace
Medicine in Germany, which has provided a wealth of
information on the effect of aircraft noise on sleep. They
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Hume: Noise induced sleep disturbance

recorded a total of 2,240 subject nights in both the laboratory

and field. This database provided clear results in terms of
changes in the macrostructure of sleep stages, immediate
event related analysis, dose response relationships between
aircraft maximum sound pressure levels and the probability
of awakening.[13] The DLR group also applied their findings
directly to the difficult practical problems of noise disturbance
around busy airports and developed the concept of noise
protection zones on the basis of sleep disturbance rather
than the traditional noise contours which are based solely on
acoustic criteria.[14]
The World Health Organization (WHO European Office)
has been instrumental in bringing experts together in recent
years and preparing documents with focus on establishing
Night Noise Guidelines for Europe,[15] Aircraft Noise and
Health and Practical Guidance for Health Risk Assessment
of Environmental Noise in Europe, which contain up-todate reviews of noise and sleep disturbance and the potential
risk to health. The WHO, NNG summarize the relationship
between night noise and health effects in the population into
four ranges of continuous outside sound level at night Ln:
<30 dB no substantial biological effects could normally be
expected;
30-40 dB primary effects on sleep start to emerge and
adverse effects in vulnerable groups;
40-55 dB sharp increase in adverse health effects while
vulnerable groups become severely affected;
>55dB adverse health effects occur frequently with high
percentage of the population highly annoyed.
These guidelines are a bold first step to lay down some easily
understood guidelines based on research carried out mainly in
Europe and provide a clear and simple guide for airports and
planners. The fuller understanding of the effect of noise on
sleep depends to a large extent on more fully understanding
the fundamental questions of the nature and function of
sleep. For example, it is now emerging that besides its
major restorative function it is suggested that sleep plays
an important role in brain plasticity mechanisms and work
on memory consolidation during sleep indicates the roles of
SWS for explicit contents and REM for implicit contents has
shown considerable advance in recent years. Therefore, the
more we understand what undisturbed sleep does, the more
we will understand what deficits will be incurred when sleep
is disturbed.
One direct advance in sleep research which benefits our
fuller understanding of the effects of noise on sleep is work
into establishing the level and nature of normal values of
spontaneous arousals and perturbations that occur in sleep,[16]
which allows clearer assessment and identification of what
may be a significant increase due to some potential sleep
disturbing factor such as noise. Also, studies directed at
understanding the essential link between EEG arousals, sleep
fragmentation and reduced daytime functioning.[17]
73

The most generalized disturbing noise in the urban and

suburban environment, where most of the populations in the
developed world live, is transportation noise, particularly
due to road, rail and specifically air traffic. This was again
reflected at ICBEN 2008, where as in previous years,
transportation noise and particularly aircraft noise dominated
concern and research affecting sleep.
Besides the acute waking and arousal affects on sleep due to
noise that can be monitored via polysomnography, actimetry
and behavioral response, there are potential chronic additive
effects of nightly noise which have the potential to contribute
to cardiovascular disease (CVD). The HYENA (Hypertension
and exposure to noise near airports) study[18] conducted around
six major European airports found a significant odds ratio for the
risk of hypertension being associated with the night noise level
(Ln). This and other studies provide sufficient evidence for a
positive association between aircraft noise and cardiovascular
disease but because of a lack of consistent end-points and
uniform methodologies it is difficult to arrive at a threshold
level for pathology onset and a simple dose-response curve. It
has to be remembered that there are well over a 100 putative risk
factors identified for cardiovascular disease which make any
rigorous investigation and analysis of the etiological pathway
a difficult task. There have been suggestions in the literature
that annoyance is the mediating factor between noise exposure
and CVD with annoyance has associations with a number of
cofactors like noise sensitivity, negative affectivity and mental
health, which fit stress models in that the inability to cope
with the environmental noise stressor is the crucial etiological
link.[19] It should not be forgotten that there are internal as well
as external causes of sleep disturbance. Internally, there are
various sleep pathologies like sleep apnea, somatic illnesses
like. Infections and factors of a more psychological origin
like anxiety and stress which are frequently work related. So
there is a need to appreciate the additive disruptive aspect of
environmental noise and incipient sleep pathology as sleep
disorders are common >10% in the general population and
increase with age, with many going undetected because of
lack of awareness by community doctors and the general
public. This presents an additional difficulty in ascribing sleep
disturbance to a specific external cause and emphasizes the
case for adequate screening and internal control measures for
subjects.

Continuing and Emerging Issues

There are many indications that the number of people
exposed to transportation noise and particularly aircraft noise
disturbance will increase over the next 20-30 years. There
have been substantial increases in aircraft noise over the last
five years, however, the recent global economic slow-down
may reduce the rate of growth for a year or two. Concern
and action to limit aircraft carbon emissions in the future
may further complicate future predictions as noise reduction
usually has an energy cost.
Noise & Health, April-June 2010, Volume 12

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Europe and other regions have witnessed a marked increase

in low cost budget air operations over recent years, which
has had the effect of increasing air travel and, due to limited
capacity at the major airports, this market has tended to
move to smaller regional airports. This has increased the
number of flights at these traditionally quiet airports and,
importantly, they tend to have a much lower ambient noise
level compared to the major airports which are usually found
in larger conglomerations. Therefore the potential for aircraft
noise disturbance has increased and spread.
Despite the majority of larger European airports being
subjected to noise related capacity constraints, many airports
are developing, wherever possible, to maximize their customer
throughput and profit. Additionally, with the awakening
of sleeping giants in Asia (China and India), global travel
is set to rise at a considerable rate as economic prosperity
and affluence is linked with industry, trade and travel. In
parallel to the recent and projected increase in aircraft noise
disturbance there are increases in the expectations of the
quality-of-life which is seen in the heightened sensitivity and
reduced tolerance in noise-affected communities.
As a consequence of the complexity that contributes to
peoples perceptions and response to disturbance, acoustic
variables (e.g. Leq noise contours), on their own, have not
been able to satisfactorily predict annoyance and complaints
regarding environmental noise.[20] The problem of aircraft
noise involves a complex interaction of a number of nonacoustic factors including psychological and sociological
issues. As a result there are a number of research groups
investigating the non-auditory affects of noise like annoyance.
In the past there has been considerable technical
improvement like changes in engine designs that have led to
reduced noise; however, the potential for substantial, further
reduction in engine noise seems limited. On the contrary,
new technologies aimed at counteracting carbon emission
and global warming lead to increase in noise. For example,
the open rotor engine, may achieve development in 10-20
years and is projected to give significantly more fuel efficient
and less carbon dioxide per air mile, but more noise. So, the
noise for the relatively few people who live near airports may
have to increase for the good of the worlds population as a
whole.

Future Research
In terms of methodological issues concerning noise and sleep
disturbance: EEG-based studies have remained the goldstandard as sleep is a phenomenon uniquely associated with
the brain whose gross activity is directly measured by EEG.
REM sleep needs EOG and EMG additionally for correct
classification, but such polysomnography is expensive; ECG
and other autonomic measures are useful in determining
cardiovascular responses to noise stimuli and can provide
Noise & Health, April-June 2010, Volume 12

insights into disease etiology; actimetry is a convenient

adjunct, cost-effective, easy to use and analyze, but its
interpretation is not precisely clear; signaled awakening
again provides a simple and convenient technique but can be
prone to problems of compliance and lacks sensitivity; sleep
logs and questionnaires provide useful subjective data and
complaints have motivation issues but provide constant feedback and are key drivers in the political arena.
Field research into the effects of noise on sleep is essential
for realism while laboratory studies can deliver appropriate
high levels of control of confounding variables that are
usually present in the field. Therefore both these types of
study are important. Early field studies showed much less
sleep disturbance than predicted by laboratory results. This
has been explained by a lack of habituation in the laboratory
setting.[21]
Despite all the work in this area there is still uncertainty as
to the long term health consequences of night-time noise
disturbance on exposed populations. Some authors have
commented on the lack of an epidemiological study that
shows a causal link between (aircraft) noise, sleep disturbance
and long-term illness. So, there is still a need for large scale
field studies with representative samples of the population to
investigate the association between night-time aircraft noise
exposure and cardiovascular disease. The cost of large scale
EEG-based studies is considerable and a more cost-effective
technique is needed.
A new technique being developed as an asset in the field
of noise and sleep disturbance is an ECG-based algorithm
for the automatic identification of autonomic activations
associated with cortical arousals, which saves considerable
human analysis time and aids consistency and objectivity.[22]
A new methodology which utilizes and combines relatively
simple yet robust signals such as ECG and actimetry may
provide cost effective tools.
Looking to the future, there is potential for exciting
development to greatly increase our ability to access
considerable field data due to the greatly increasing number
of households linked by broadband internet services and
WiFi in developed countries; for example, US and Western
Europe. This could allow residents from wide areas like
around airports, to pass digital information when they would
normally be off-line as in bed at night, to a central receiver
and analysis point which could also collect co-terminus noise
and flight data. There would have to be some development
and suitable interfacing to transmit, like electrophysiological
data, actimetry and simple subject signaling like time of
attempting to sleep. Therefore, ECG and actimetry combine
to present themselves as robust and easily recorded signals
that would be ideal for this system and, in combination with
new analysis algorithms, utilizing these simple and relatively
inexpensive techniques, combine with subject signaling. All
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these need to be developed to provide a new cost effective

sleep recording technique suitable for epidemiological
studies.
Delayed sleep onset and premature awakening can be
extremely annoying experiences and are frequently
complained about. Community complaints and annoyance
have been key drivers in the political noise arena. There has
been some work to systematically analyze complaints and
annoyance in high noise areas to better understand these
issues.[23] The basic rationale is that the data is provided
free, provides a rapid feedback and reflects specific area
annoyance. This provides a better understanding of how
noise affects individuals and provides evidence for pilots,
airlines and airports to modify operating systems to reduce
noise exposure in affected areas. More use could be made
of complaints if airports ensured that there was (1) adequate
awareness of the complaint system (2) ease of inputting a
complaint with standardized formats and procedures (3)
logging, response and reporting procedures (4) application of
GPS (5) use of simple metrics to allow comparison within
and between airports.
The problems of road, rail and air traffic have become major
issues at the local level with noise and air quality and at the
global level with carbon emission and global warming.[8]
There has been significant work completed on combined
transportation modes and how additive the disturbance
was addressed in papers at ICBEN 2008. In the future the
combined effects of noise exposure with other agents like
poor local air quality on health needs to be further addressed.
Wind turbines as alternative power sources to carbon fuels
have developed at a much more rapid pace than was foreseen
five years ago. They have considerable potential to add to
the noise burden and disturb sleep. Fortunately, until now,
these wind-farms have generally been sited in very exposed
locations on the tops of mountains and at sea i.e. well away
from the main areas of human habitation. However, they pose
a potential threat to sleep as they are relatively permanent
structures and do not fly away.
The study of the increased risk in vulnerable groups including
young, old, noise sensitive, sleep disorder patients, shift
workers is frequently mentioned but rarely studied. Major
airports operate 24 hours for seven days a week and employ
considerable numbers of local staff who work night shifts;
hence it is surprising that this clearly highly vulnerable group,
who one would surmise have disturbed sleep, have not been
studied in depth to the authors knowledge.
Looking to the future and the projected increased longevity of
westernized culture due to improved life-style and healthcare,
there are predictions that the proportion of the elderly in society
will grow significantly over the next 30 years. This suggests
that the elderly, with their more fragile sleep, will become a
75

major vulnerable group as hospital patients, nursing and care

home residents. There is a literature based around noise and
sleep problems associated with hospitalization, acute/intensive
care units and institutionalization particularly in homes for the
elderly. Koch et al.[24] report that adopting a multidisciplinary
approach combining noise reduction, promotion of daytime
activity and reduction of night time nursing care were the
most effective means of promoting sleep; the long term use
of sedatives is questionable practice and overuse reduces the
quality of life of older people. As we all get older it is in our
interest to help provide the knowledge to aid sleep and improve
the quality of wakefulness in the elderly.
Another vulnerable group, affected by sleeping in noisy
periods near airports, is children who are in bed during the
shoulder hours of airport operations, which is the hour or so
before and after the night curfew restrictions are in force. This
is a time of increased aircraft movement and it is typically a
time when children are in bed in the evening and morning.
These and many other issues would benefit from properly
planned, funded and executed research studies in the future.

Acknowledgments
The essential part of this work was initially presented at ICBEN
2008, and updated for presentation at Internoise and Euronoise 2009.

Address for correspondence:

Ken Hume,
Division of Health Science & CATE,
John Dalton Bldg., MMU, Chester St.,
Manchester M15GD, UK
E-mail: k.i.hume@mmu.ac.uk

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Source of Support: Nil, Conflict of Interest: None declared.

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