Nearly ¼ of
patients say mechanical heart valve disturbs sleep
NEARLY ¼ of patients with a
mechanical heart valve say it disturbs their sleep, according to research
presented at 'EuroHeartCare 2017.'
"I will never have silence around me again..." said 1 patient.
"For some patients the closing sound of their mechanical heart valve
reduces their quality of life, disturbs their sleep, causes them to avoid social
situations, and leads to depression and anxiety..." said lead author Dr
Kjersti Oterhals, a nurse researcher at Haukeland University Hospital in Bergen,
This study investigated how the noise of a mechanical heart valve affected
patients' lives, in particular their sleep, and whether there were any
differences between women and men.
In April 2013 all 1,045 patients who had undergone aortic valve replacement at
Haukeland University Hospital between 2000 and 2011 were invited to participate
in a postal survey. Of the 908 patients who responded, 245 had received a
mechanical valve and were included in the current analysis.
Patients were asked if the valve sound was audible to them or others, if they
sometimes felt uneasy about the sound, if the sound disturbed them during
daytime or during sleep, and whether they wanted to replace the mechanical valve
with a soundless prosthetic valve if possible. Patients ranked the noise on a
scale of 0 (does not disturb them at all) to 10 (causes maximum stress). The
Minimal Insomnia Symptom Scale, which consists of 3 questions about sleep,
was used to give patients a score of 0 to 12 for insomnia.
Patients were 60 years old on average and 76% were men. 23% said the valve sound
disturbed them during sleep and 9% said it disturbed them during the day. Some
28% wanted to replace their valve with a soundless prosthetic valve if possible.
51% said the noise was often or sometimes audible to others, but only 16% said
they sometimes felt uneasy about others hearing it.
The researchers found that 87% of men and 75% of women said that they were able
to hear the closing sound of their mechanical valve. Women were more disturbed
by the valve sound than men.
Some 53% of the respondents had no insomnia, 31% had subclinical insomnia, and
17% had moderate to severe insomnia. Valve noise perception was the strongest
predictor of insomnia, followed by age, and female gender. There was a linear
association between insomnia and valve noise perception. And the more patients
considered the valve noise a disturbance in daily life, the more insomnia they
Dr Oterhals said:- "Almost ¼ of patients said
that the sound of their mechanical heart valve makes it difficult for them to
sleep. Most of us need a quiet environment when we are going to sleep and these
patients found it hard to ignore the noise from the valve."
Not all patients are aware before surgery that they may hear their mechanical
valve, and while most get used to it, for some it is troublesome for many years.
"One female patient said to me... 'I will never have silence around me
again' when she realised she would hear the noise 24 hours a day for the rest of
her life..." said Dr Oterhals.
The most common ways patients coped with the noise when trying to sleep were to
sleep on their right side which reduced the valve noise, put the duvet around
their bodies to isolate the sound, listen to music, and do relaxation exercises.
Ear plugs were not effective and made the valve noise louder.
Dr Oterhals said:- "We are not very proactive about this issue at the
moment. It would improve many patients' quality of life if we asked them about
valve noise and provided advice to those who find it distressing."