White Noise and Its Impact on Alcohol Withdrawal
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Date
2018-05
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The Ohio State University
Abstract
Title: The Impact of White Noise on Alcohol Withdrawal: A Pilot Study Purpose: To examine the impact of white noise on patients experiencing alcohol withdrawal in the inpatient setting. Background/significance: Almost half of the adult US population report regular alcohol use. For patients who consume alcohol on a daily basis, admission to an acute care facility means potentially experiencing withdrawal. Theoretical Framework: Stochastic resonance (SR) is a phenomenon where random noise plays a beneficial role in enhancing the detection of weak information-carrying signals. The SR model hypothesized that a moderate amount of auditory noise benefit individuals in a hypo-dopaminergic states such as occurs in those experiencing alcohol withdrawal (Söderlund et al., 2010). Method: This was a quasi-experimental study. We examined the difference between a prospective group of subjects experiencing alcohol withdrawal exposed to white noise and compared their use of antianxiety medications with a retrospective group of similar patients who were not exposed. The setting was at a community hospital which is affiliated with an academic medical center. Inclusion criteria included: (1) 18 years of age or older, (2) English speaking, (3)oriented, (4)able to sign consent form, (5) have the CIWA-Ar protocol order and (6) admitted to a medical –surgical unit or the progressive care unit. The sample size was 30 persons per group. For subject in the prospective group, the white noise machine was placed in the subject's room. Subjects were observed, assessed and treated with the current hospital Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) protocol. Documentation included the CIWA-AR scale and frequency and dose of anti-anxiety medications. For the retrospective group, a randomized list of 30 subjects who met inclusion criteria was obtained from the data warehouse. The same data was collected on these subjects. Descriptive statistics were used to analyze demographic and clinical data. Inferential statistics were used to compare antianxiety medication dosing and frequency between the two groups. Results: Descriptive statistics were used to analyze demographic and clinical data while Inferential statistics were used to compare the anxiety medication between the two groups. In regards to statistical significance, the retrospective group received a higher dose of Ativan on Day 2, (x=4.5mg, SD=4.0) than the prospective group (x=.75mg, SD=1.7), (t=-2.42, p=<.02); and at a higher frequency (t=-2.05, p=<.05). Conclusions: Although the other days of observation (days 1,3-4) showed no statistical differences between the groups, overall the retrospective group had higher CIWA scores; suggesting some clinical relevancy. This was a pilot study and limited by small sample size. We recommend replicating this study in a patient population with higher admitting CIWA scores and with a large sample size.
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Keywords
white noise, alcohol withdrawal, CIWA-Ar scale, CAM