A quarter of patients with mechanical heart valves claim that the valves disturb their sleep, according to a new study.

“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 Kjersti Oterhals, a nurse researcher at Haukeland University Hospital in Bergen, Norway, and lead author on the study, in a press release.

The study examined how mechanical heart valve noise affected the lives of men and women patients who had one implanted.

Patients who had an aortic valve replacement at Haukeland University Hospital between 2000 and 2011 were asked to participate in an optional post-operative survey. Out of the 1,045 patients contacted, 908 answered, and 245 of them reported having a mechanical valve and were used for the study.

The patients were asked to rate if the valve made a sound that was audible to them or other people on a scale of 0 (no disruptions) to 10 (causes maximum stress) and if the sound created an uneasy feeling. Researchers also asked if the sound was disruptive during the day and while sleeping and if they would rather replace the mechanical valve with a soundless prosthetic valve. They were asked to rate the sound disruption on the Minimal Insomnia Symptom Scale as well, which consists of 3 sleep-related questions, and give a score of 0 to 12 for insomnia.

On average, the patients were 60 years old and 76% men. Nearly a fourth reported the valve sound being disruptive during sleep, and 9% reported daytime disruptions. Over half of the patients reported the sound being too often and could be heard by others, but only 16% said it created an uneasy feeling. Additionally, 28% said they would replace their valve with a soundless prosthetic valve if given the opportunity.

There was no reported insomnia among 53% of the patients, 31% reported having subclinical insomnia and 17% had moderate to severe insomnia.

“Almost one-fourth 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,” Oterhals said.

The study reports that patients began to sleep on their right sides when the noises from the valve became too loud. They also wrapped a duvet around their bodies, listened to music and did relaxation exercises.

“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,” said Oterhals.

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