Mechanical heart valves can save the lives of patients, but one disadvantage is that they may cause sleepless nights.
Nearly one in four people with a mechanical heart valve says the noise it makes disrupts their sleep, a new study finds.
“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 study lead author Kjersti Oterhals. She is a nurse researcher at Haukeland University Hospital in Bergen, Norway.
Noise hard to ignore
The Norwegian researchers surveyed 245 patients with a mechanical aortic heart valve. The participants’ average age was 60. 87% of men and 75% of women said that they were able to hear the valve. 23% said the sound disturbed them during sleep and 9% said it disturbed them during the day.
“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.
Just over half said the noise could often or sometimes be heard by others, but only 16% said they sometimes felt uneasy about others hearing it.
About 28% of the patients said they would have their mechanical valve replaced with a soundless prosthetic valve if possible, the study revealed.
31% of the patients had mild insomnia and 17% had moderate to severe insomnia. Awareness of valve noise was the strongest predictor of insomnia, followed by age, and being female.
Oterhals is scheduled to present the study’s findings at the European Society of Cardiology meeting in Jonkoping, Sweden.
‘I will never have silence around me again’
Not all patients knew before they received their mechanical heart valve that they might be able to hear it. Most people eventually get used to the sound, the researchers said. But for others, the noise is more distressing.
“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,” Oterhals said in a meeting news release.
Another disadvantage is that patients with mechanical heart valves are typically put on blood thinners or drugs that combat clotting to prevent a heart attack or stroke. The blood thinner Pradaxa raises the risk of both dangerous clots and bleeding around the heart.
But the danger of these drugs is a risk for severe bleeding.
Patients also require repeated, invasive and risky open-heart surgery, as the repairs to severely damaged heart valves can deteriorate over time.
A less intrusive alternative – established at Netcare Union Hospital in Alberton, Johannesburg – is the percutaneous repair of heart valves through a small puncture in the groin.
Managing the noise
Common ways that patients dealt with valve noise while in bed included:
- Sleeping on their right side in order to reduce the valve noise
- Putting a duvet around their bodies to isolate the sound
- Listening to music,
- Doing relaxation exercise
Earplugs were not effective and made the valve noise louder, the researchers said.