374 - DREAMIES: A novel hearing protection device to facilitate sleep in hospitalized neonates

Poster Number: 374
Publication Number: 374.133

Elisabeth Bloch-Salisbury, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Lauren McKenna, University of Massachusetts Medical School, Worcester, MA, United States; Donald F. Chin, UMass Memorial Children's Medical Center, Worcester, MA, United States

Background: Sleep is critically important for the developing newborn. Premature infants often require prolonged hospitalization in the neonatal intensive care unit (NICU) where they are exposed to adverse noise that may disrupt sleep and further compromise recovery and developmental outcomes. Interventions are needed to protect hospitalized neonates from detrimental noise.

Objective: A single-center trial (NCT03881553) assessed whether a novel circumaural hearing protection device (DREAMIES, NEATCAP Medical LLC), designed to simulate acoustic filtering of a pregnant woman’s womb by reducing high-frequency loud noise, improved sleep in hospitalized premature newborns.

Design/Methods: Ten premature infants (mean 34.1 weeks GA; 5 male; 6 white; 3 Hispanic/Latino) participated in a single-session study. A within-subject design was used to compare infant’s sleep state measured by polysomnography for three contiguous interfeed periods throughout which DREAMIES were worn (ON) or not worn (OFF). All infants received the same condition order (OFF1-ON-OFF2). Continuous 30-sec epochs were scored throughout the study session as Quiet Sleep (QS), Active Sleep (AS), Indeterminate Sleep (IS), or Wake; scorer was masked to the DREAMIES condition. Sound levels were measured near the infant’s head throughout the interfeed intervals.

Results: There was no difference in the duration of the three interfeed periods (respective OFF1-ON-OFF2, median 116, 120, 116 min). Illustrated in Figure 1, there was a 20.3% increase in sleep from OFF1 to ON and an 14.7% decrease in sleep from ON to OFF2. There was a marginal effect of DREAMIES on percent sleep (χ2 =5.03, P=0.08) with significantly more sleep for ON1 compared to OFF1 (P=0.05) and to OFF2 (P=0.02); an analogous effect of the device was observed for Wake. There was a main effect of DREAMIES on AS (χ2 =7.4, P=0.025) largely due to more AS for ON1 (median 37%) compared to OFF2 (median 32%; P=0.074). There was no statistically significant effect of DREAMIES on QS or IS. On average, sound level was 51dB (range 45-113 dB) and did no differ significantly among the three periods.Conclusion(s): This study examined a recently developed neurosensory adaptive technology intervention for reducing adverse noise exposure in hospitalized neonates and found sleep was increased when infants wore the device compared to preceding and succeeding periods when the device was not worn. Given the wide range of recorded noise levels throughout the periods, findings suggest DREAMIES may augment sleep in premature infants by reducing acute episodes of adverse noise in the NICU.

Support: R01DA042074; U54HL143541
Sleep is increased during interfeed periods with DREAMIES ON compared to interfeed periods with DREAMIES OFF.Median values and inter-quartile range (n=10 premature infants); *P=0.05; **P=0.02.