Noise-induced Sleep Disturbance Research Articles

Effects of personal noise exposure, sleep quality, and burnout on quality of life: An online participation cohort study in Taiwan

Chronic noise exposure in daily life not only causes physical and mental illness but also reduces quality of life. However, collecting objective data on sound exposure and subjective acoustic comfort through a traditional one-shot survey is difficult. This study applied online chatbots in social media to explore the effects of daily sound exposure, personal characteristics, noise sensitivity, burnout status, and sleep quality on quality of life using a short-term participatory cohort design. During the two-month survey in 2022, 207 participants completed at least 15 days of collection of data on sound exposure and perception, as well as periodic structural questionnaires during the follow-ups. Linear regression and generalized linear models were applied to explore the factors influencing personal burnout, the Pittsburgh Sleep Quality Index, and quality of life. A chain mediation model was applied to explore the direct and indirect effects of noise exposure on quality of life. The results showed a better quality of life among respondents who rated their home environment better, were in good health, had better daily acoustic comfort, and were less exposed to noise during the week. In contrast, respondents with lower daily acoustic comfort and a higher frequency of noise-induced sleep disturbances and mood disorders were more likely to have poorer sleep quality. A higher personal burnout was associated with poorer health, longer exposure to noise during the week, a higher frequency of noise-induced illnesses, and neurotic traits. In the mediation analyses, noise-induced sleep disturbance and better daily acoustic comfort also had important direct influences on quality of life compared to the indirect pathway through sleep quality and personal burnout. In conclusion, noise exposure in daily life not only exacerbated poor sleep quality and personal burnout but also reduced quality of life.

Introducing ICBEN's new socio-acoustic survey archive ISAR

The International Committee on Biological Effects of Noise (ICBEN) has recently started an international archive of original survey response data from so called socio-acoustic noise surveys, named ISAR (ICBEN Socio-Acoustic Survey Archive). The ISAR archive caters to noise effects researchers around the globe and enables pooled analyses, establishment of generalized exposure-response relationships, trend analyses both spatially and temporally, as well as cross-cultural comparisons of self-reported noise reactions (noise annoyance and noise-induced sleep disturbances in particular). The data in the archive will be freely accessible. Data in the ISAR archive are fully anonymous in order to meet the pertinent data protection regulations in most countries. The ISAR archive is curated by ICBENs officers and the team chairs of Team 6 (Community response to noise and annoyance). The ISAR archive explicitly collects only raw survey response data, rather than data that have been aggregated on a higher level. We are constantly seeking to extend the archive with new study data and thus, every new contribution is highly welcome. In this talk, we would like to publicize and promote the archive and encourage our colleagues to share their survey data with the archive.

The impact of nocturnal road traffic noise, bedroom window orientation, and work-related stress on subjective sleep quality: results of a cross-sectional study among working women

ObjectiveTo examine the effect of work-related stress and road noise exposure on self-rated sleep and potential additive interaction effects.MethodsSleep and predictor variables were surveyed within two subsamples with 2191 and 1764 working women in a cross-sectional study. Sleep was assessed using a single question on general sleep quality and four questions on specific sleep problems and subsequently dichotomized (poor sleep vs. no poor sleep). Work-related stress was operationalized by job strain and effort-reward imbalance. Nocturnal exposure to road traffic noise was assessed as (a) the orientation of the bedroom window to a quiet façade vs. a low-, medium- or high-trafficked street and (b) energy-equivalent sound pressure levels for night-time modelled at the most exposed façade (Lnight). We distinguished between low (< 45 dB(A)), medium (45–50 dB(A)) and high exposure (> 50 dB(A)).ResultsPoor sleep was associated with job strain and effort-reward imbalance. The prevalence of poor sleep did not increase with increasing Lnight, but bedroom window orientation showed a non-significant trend. A quiet façade had a protective effect on sleep in each Lnight category. We found a non-significant trend for an additive interaction between bedroom window orientation and job strain.ConclusionNoise levels modelled for the most exposed façade likely overestimate the actual exposure and thus may not be a precise predictor of poor sleep. Bedroom window orientation seems more relevant. Potential additive interaction effects between bedroom window orientation and job strain should be considered when interpreting epidemiological study results on noise-induced sleep disturbances.

Exposure to the road traffic noise in an urban complex in Greece: the quantification of healthy life years lost due to noise-induced annoyance and noise-induced sleep disturbances.

In the recent years, the environmental noise is a global issue of great concern. Especially, it is considered to be one of the most deleterious environmental risk factors for the human health and well-being in urban areas. In this study, we focus on the major source of the transportation noise in the modern-day urbanized societies, which is the road traffic noise. The study was performed in the urban complex in Thessaloniki-Neapoli in Greece, and the estimation of the road traffic noise levels was based on the CoRTN (Calculation of Road Traffic Noise) prediction method. In addition, we estimated the EBD (environmental burden of disease), in terms of DALYs (disability-adjusted life years), due to the annoyance and sleep disturbances associated with the exposure to road traffic noise. The estimation of the EBD was based on the strategic noise mapping in Thessaloniki-Neapoli as well as on the guidance document produced by the WHO (World Health Organization) for the quantitative assessment on the humans' health consequences of the environmental noise. Above all, the results revealed the magnitude of the health damage caused by the transportation noise.

Assessment Methods and Factors Determining Positive Indoor Soundscapes in Residential Buildings: A Systematic Review

The design of an indoor acoustic environment positively perceived by building occupants requires a perceptual approach to be adopted in order to define what makes it sound good. Soundscape standards ISO 12913 have been introduced to assess how the acoustic environment is perceived, in context, by people. According to the standards, a straightforward characterization of a soundscape as positive is currently possible only through measurements by persons, because of a current gap in linking perceptual metrics to acoustic or psychoacoustic measurements. In addition, despite applying also to indoor contexts, methods and perceptual metrics described by the standards have been mainly derived from studies related to outdoor urban environments and it is not clear whether they could be directly applied indoor. For this reason, a systematic review was performed to investigate: (i) Data collection methods used in the literature for indoor residential soundscapes and (ii) factors, output of such methods, that characterize them positively. For this purpose, a systematic review has been conducted in accordance with the PRISMA guidelines (preferred reporting items for systematic reviews and meta-analyses) guidelines. The Scopus database was searched for peer-reviewed journal papers published in English, between 1 January 2009 and 24 June 2019, including: (1) field or laboratory studies relevant to residential buildings and (2) studies assessing factors that influence the perception by building users of indoor acoustic environments. The search excluded studies related to: (a) Speech perception issues; (b) noise-induced sleep disturbance; (c) acoustic perception by hearing impaired building users; (d) perception of vibrations or impact sounds. The search returned 1087 results. After the screening process, 37 articles were finally included. Given the differences in methodologic approaches, a quantitative meta-analysis could not be performed, and a qualitative approach was adopted instead. A large part of the selected literature reflected a general effort of minimizing noise annoyance by reducing noise exposure and, in particular, noise levels. Questionnaires and guided interviews were used to capture people’s perception, while the adoption of soundwalks and non-participatory behavioral studies did not emerge in the review literature and need further investigation. The evaluation of a variety of auditory sensations both in their positive and negative dimensions, beyond annoyance, would be required to explore the positive perceptual potential of sounds. Besides sound level, a variety of factors related and unrelated to the acoustic environment were found to affect perceptual outcomes and a framework of evaluation has been proposed as a reference for future assessments. Results encourage the integration of soundscape methodologies into IEQ research, in order to enhance user health and well-being.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Effects on Sleep.

To evaluate the quality of available evidence on the effects of environmental noise exposure on sleep a systematic review was conducted. The databases PSYCINFO, PubMed, Science Direct, Scopus, Web of Science and the TNO Repository were searched for non-laboratory studies on the effects of environmental noise on sleep with measured or predicted noise levels and published in or after the year 2000. The quality of the evidence was assessed using GRADE criteria. Seventy four studies predominately conducted between 2000 and 2015 were included in the review. A meta-analysis of surveys linking road, rail, and aircraft noise exposure to self-reports of sleep disturbance was conducted. The odds ratio for the percent highly sleep disturbed for a 10 dB increase in Lnight was significant for aircraft (1.94; 95% CI 1.61–2.3), road (2.13; 95% CI 1.82–2.48), and rail (3.06; 95% CI 2.38–3.93) noise when the question referred to noise, but non-significant for aircraft (1.17; 95% CI 0.54–2.53), road (1.09; 95% CI 0.94–1.27), and rail (1.27; 95% CI 0.89–1.81) noise when the question did not refer to noise. A pooled analysis of polysomnographic studies on the acute effects of transportation noise on sleep was also conducted and the unadjusted odds ratio for the probability of awakening for a 10 dBA increase in the indoor Lmax was significant for aircraft (1.35; 95% CI 1.22–1.50), road (1.36; 95% CI 1.19–1.55), and rail (1.35; 95% CI 1.21–1.52) noise. Due to a limited number of studies and the use of different outcome measures, a narrative review only was conducted for motility, cardiac and blood pressure outcomes, and for children’s sleep. The effect of wind turbine and hospital noise on sleep was also assessed. Based on the available evidence, transportation noise affects objectively measured sleep physiology and subjectively assessed sleep disturbance in adults. For other outcome measures and noise sources the examined evidence was conflicting or only emerging. According to GRADE criteria, the quality of the evidence was moderate for cortical awakenings and self-reported sleep disturbance (for questions that referred to noise) induced by traffic noise, low for motility measures of traffic noise induced sleep disturbance, and very low for all other noise sources and investigated sleep outcomes.

Evaluation of an ANSI standard for predicting transportation noise-induced sleep disturbance

An ANSI Working Group has completed its review of a noise-induced sleep disturbance standard (Part 6 of ANSI/ASA S12.9-2008) by deciding not to re-affirm it. The Working Group’s decision was based on the relatively small and non-representative corpus of field observations of noise-induced behavioral awakenings available for analysis; on the poor generalizability of predicted awakening rates from airport to airport; on practical experience with the limited utility of predictions of “at least one behavioral awakening per night” for purposes of assessing environmental noise impacts; on the statistical assumptions of convenience and post hoc analysis methods used to generate predictions of awakenings; on information published subsequent to adoption of the original standard; and on the findings of peer-reviewed re-analyses of the findings on which the original standard was based. The Working Group further recommended that no further analytic effort intended to develop alternate awakening prediction methods be undertaken until a substantial body of new peer-reviewed field observations has been published.

Long-term exposure to transportation noise and air pollution in relation to incident diabetes in the SAPALDIA study.

BackgroundEpidemiological studies have inconsistently linked transportation noise and air pollution (AP) with diabetes risk. Most studies have considered single noise sources and/or AP, but none has investigated their mutually independent contributions to diabetes risk.MethodsWe investigated 2631 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), without diabetes in 2002 and without change of residence between 2002 and 2011. Using questionnaire and biomarker data, incident diabetes cases were identified in 2011. Noise and AP exposures in 2001 were assigned to participants’ residences (annual average road, railway or aircraft noise level during day-evening-night (Lden), total night number of noise events, intermittency ratio (temporal variation as proportion of event-based noise level over total noise level) and nitrogen dioxide (NO2) levels. We applied mixed Poisson regression to estimate the relative risk (RR) of diabetes and their 95% confidence intervals (CI) in mutually-adjusted models.ResultsDiabetes incidence was 4.2%. Median [interquartile range (IQR)] road, railway, aircraft noise and NO2 were 54 (10) dB, 32 (11) dB, 30 (12) dB and 21 (15) μg/m3, respectively. Lden road and aircraft were associated with incident diabetes (respective RR: 1.35; 95% CI: 1.02–1.78 and 1.86; 95% CI: 0.96–3.59 per IQR) independently of Lden railway and NO2 (which were not associated with diabetes risk) in mutually adjusted models. We observed stronger effects of Lden road among participants reporting poor sleep quality or sleeping with open windows.ConclusionsTransportation noise may be more relevant than AP in the development of diabetes, potentially acting through noise-induced sleep disturbances.

Effect of occupational noise-induced sleep disturbance on worker's health

Aims: In addition to the noise, sleep disturbance (SD) as an outcome of the exposure to the wind turbine noises (WTNs) can adversely affect general health. This study aimed to investigate the effect of SD induced from WTNs on general health indicators. Materials and Methods: A total number of fifty tree workers from Manjil wind farm voluntarily participated in this study. Based on the job similarity and vicinity to the sound sources, workers were classified into three occupational groups including repairman, security, and official staff. Individual's health and sleep status were gathered using the 28-item General Health Questionnaire and Epworth Sleepiness Scales, respectively. Noise was measured based on ISO 9612. ANOVA, Chi-square, and linear and multiple regression tests were used for data analysis in the SPSS 20 software environment. Results: The mean values of 8-h equivalent continuous A-weighted sound pressure level (LAeq, 8 h) among whole workers was 71 ± 10 dB (A). The averages of somatic symptom, anxiety insomnia, social dysfunction, depression, and general health among the participants were 5 ± 2.44, 7 ± 2.35, 11 ± 2.65, 2 ± 1.54, 22 ± 6.53, and 7.3 ± 3.1, respectively. According to the results, SD and noise exposure had an adverse health effect on physical symptoms, depression, and overall general health of participants. Moreover, SD and work experience were effective factors on anxiety-insomnia. SD had greatest effect on general health when all variables are controlled, so that general health will increase by 2.42 units for each unit increase of SD. Conclusion: We found that in addition to the sound effect, noise-induced SD also affects worker's health and strengthen sound effects on human well-being.

Pregnancy and childhood exposure to residential traffic noise and overweight at 7 years of age

BackgroundExposure to road traffic noise has been associated with adiposity and diabetes in adults. The suggested pathways have been through sleep disturbance and stress. Children may be particularly susceptible to noise induced sleep disturbance and stress and the effects hereof. ObjectivesTo examine the association between traffic noise exposure during pregnancy and early childhood and adiposity in children. MethodsWe identified 40,974 singletons from the Danish National Birth Cohort with parentally given questionnaire information on weight and height at 7-years of age. Road and railway traffic noise were modeled at all historical addresses and expressed as time-weighted means for two exposure periods (pregnancy and childhood). Adiposity was assessed using BMI z-scores and a dichotomous measure of childhood overweight based on age and sex specific cut-offs. Associations were analyzed using linear regression for BMI z-scores and logistic regression for risk of childhood overweight, adjusting for socioeconomic position, maternal BMI, maternal smoking, maternal age, parity and degree of urbanization. ResultsWe found both pregnancy and childhood exposure to road traffic noise to be associated with a higher risk for childhood overweight (odds ratio (OR)=1.06 per 10dB, 95% confidence interval (CI): 1.00–1.12 for exposure during pregnancy and OR=1.06 per 10dB, 95% CI: 0.99–1.12 for childhood exposure). There were no associations between road traffic noise and BMI z-scores. We found no associations between railway noise and adiposity. ConclusionsWe found suggestions of a positive association between road traffic noise and risk of overweight in 7-years old children.

Inter-individual Differences in the Effects of Aircraft Noise on Sleep Fragmentation.

Environmental noise exposure disturbs sleep and impairs recuperation, and may contribute to the increased risk for (cardiovascular) disease. Noise policy and regulation are usually based on average responses despite potentially large inter-individual differences in the effects of traffic noise on sleep. In this analysis, we investigated what percentage of the total variance in noise-induced awakening reactions can be explained by stable inter-individual differences. We investigated 69 healthy subjects polysomnographically (mean ± standard deviation 40 ± 13 years, range 18-68 years, 32 male) in this randomized, balanced, double-blind, repeated measures laboratory study. This study included one adaptation night, 9 nights with exposure to 40, 80, or 120 road, rail, and/or air traffic noise events (including one noise-free control night), and one recovery night. Mixed-effects models of variance controlling for reaction probability in noise-free control nights, age, sex, number of noise events, and study night showed that 40.5% of the total variance in awakening probability and 52.0% of the total variance in EEG arousal probability were explained by inter-individual differences. If the data set was restricted to nights (4 exposure nights with 80 noise events per night), 46.7% of the total variance in awakening probability and 57.9% of the total variance in EEG arousal probability were explained by inter-individual differences. The results thus demonstrate that, even in this relatively homogeneous, healthy, adult study population, a considerable amount of the variance observed in noise-induced sleep disturbance can be explained by inter-individual differences that cannot be explained by age, gender, or specific study design aspects. It will be important to identify those at higher risk for noise induced sleep disturbance. Furthermore, the custom to base noise policy and legislation on average responses should be re-assessed based on these findings.

A Neurophysiological Approach for Evaluating Noise-Induced Sleep Disturbance: Calculating the Time Constant of the Dynamic Characteristics in the Brainstem.

Chronic sleep disturbance induced by traffic noise is considered to cause environmental sleep disorder, which increases the risk of cardiovascular disease, stroke, diabetes and other stress-related diseases. However, noise indices for the evaluation of sleep disturbance are not based on the neurophysiological process of awakening regulated by the brainstem. In this study, through the neurophysiological approach, we attempted (1) to investigate the thresholds of awakening due to external stimuli in the brainstem; (2) to evaluate the dynamic characteristics in the brainstem and (3) to verify the validity of existing noise indices. Using the mathematical Phillips–Robinson model, we obtained thresholds of awakening in the brainstem for different durations of external stimuli. The analysis revealed that the brainstem seemed insensitive to short stimuli and that the response to external stimuli in the brainstem could be approximated by a first-order lag system with a time constant of 10–100 s. These results suggest that the brainstem did not integrate sound energy as external stimuli, but neuroelectrical signals from auditory nerve. To understand the awakening risk accumulated in the brainstem, we introduced a new concept of “awakening potential” instead of sound energy.

Road Traffic Noise-induced Sleep Disturbances in Some Cities in Eastern Nigeria

Road Traffic Noise-induced Sleep Disturbances in Some Cities in Eastern Nigeria

Auditory and non-auditory effects of noise on health: An ICBEN perspective

Noise is pervasive in everyday life and induces both auditory and non-auditory health effects. Noise-induced hearing loss remains the most common occupational disease in the United States, but is also increasingly caused by social noise exposure (e.g., through music players). Simultaneously, evidence on the public health impact of non-auditory effects of environmental noise exposure is growing. According to the World Health Organization (WHO), ca. 1.6 Million healthy life years (DALYs) are lost annually in the western member states of the European Union due to exposure to environmental noise. The majority (>90%) of these effects can be attributed to noise-induced sleep disturbance and community annoyance, but noise may also interfere with communication and lead to cognitive impairment of children. Epidemiological studies increasingly support an association of long-term noise exposure with the incidence of hypertension and cardiovascular disease. Up-to-date exposure-response relationships are needed for health impact assessments, to reassess the validity of current noise policy and to better mitigate the negative health consequences of noise. The International Commission on Biological Effects of Noise (ICBEN) is a non-profit organization constituted 1978 that promotes all aspects of noise effects research and its application through International Noise Teams and an International Congress every three years.

The effect of the number of aircraft noise events on sleep quality

BackgroundBoth the WHO and the EC recommend the use of Lnight as the primary indicator for sleep disturbance. Still, a key question for noise policy is whether the prediction of sleep quality could be improved by taking the number of events into account in addition to Lnight. ObjectivesThe current paper investigates the association between sleep quality and the number of aircraft noise events. The first aim of this study was to investigate whether, for the purpose of predicting sleep quality measured by motility, the nummer of events is adequately represented in Lnight for the purpose of predicting sleep quality measured by motility. The second aim was to investigate whether the number of events at a given Lnight has an additional predictive value. In addition, it was explored whether the total number of events should be taken into account for the production of sleep quality, or only the number of events exceeding a certain sound pressure level. MethodsThis study is based on data of a field study among 418 people living within a range of 20km from Amsterdam Airport Schiphol. The data from this study are well suited for this purpose, since for every subject both the number and the exposure level of events are available. Sleep quality was measured by motility, derived from actimeters worn on the wrist, and by self-reported sleep quality scored on a 11-point scale. Mixed linear regression models were built in a stepwise manner to predict sleep quality during a sleep period time. ResultsThe results show that, given a certain equivalent noise level, additional information on the overall number of events does not improve the prediction of sleep quality. However, the number of events above LAmax of 60dB was related to an increase in mean motility, indicating lower sleep quality. No effect of number of events was found on self-reported sleep quality. ConclusionsThis study suggests that the number of events is more or less adequately represented in Lnight and only the number of high noise level events may have additional effects on sleep quality as measured by motility. This may be viewed as an indication that, in addition to Lnight, the number of events with a relatively high LAmax could be used as a basis for protection against noise-induced sleep disturbance.

Aircraft noise-induced awakenings are more reasonably predicted from relative than from absolute sound exposure levels

Assessment of aircraft noise-induced sleep disturbance is problematic for several reasons. Current assessment methods are based on sparse evidence and limited understandings; predictions of awakening prevalence rates based on indoor absolute sound exposure levels (SELs) fail to account for appreciable amounts of variance in dosage-response relationships and are not freely generalizable from airport to airport; and predicted awakening rates do not differ significantly from zero over a wide range of SELs. Even in conjunction with additional predictors, such as time of night and assumed individual differences in "sensitivity to awakening," nominally SEL-based predictions of awakening rates remain of limited utility and are easily misapplied and misinterpreted. Probabilities of awakening are more closely related to SELs scaled in units of standard deviates of local distributions of aircraft SELs, than to absolute sound levels. Self-selection of residential populations for tolerance of nighttime noise and habituation to airport noise environments offer more parsimonious and useful explanations for differences in awakening rates at disparate airports than assumed individual differences in sensitivity to awakening.

Noise-induced sleep disturbances and long-term health risks

Undisturbed sleep of sufficient length is essential for daytime alertness and performance, health and wellbeing. According to recent figures published by the WHO, sleep disturbance is one of the mo...

Sample size estimation for field studies on the effects of aircraft noise on sleep

Environmental noise disturbs sleep, may impair daytime performance and lead to long-term health consequences. Unbiased and precise exposure–response relationships inform the political and legislative decision making process, e.g. in the context of setting exposure limits, but up-to-date exposure–response relationships for noise-induced sleep disturbances are missing for many noise sources and countries. Sample size calculations are needed to power field studies on the effects of noise on sleep adequately, but are complicated by the fact that each investigated subject is exposed to multiple noise events (i.e., data are clustered within subjects). Using existing data of a field study on the effects of aircraft noise on polysomnographically determined awakenings and a bootstrap approach, we performed Monte Carlo simulations for the power calculations. We estimated the power of the study to find a significant effect of maximum sound pressure level and the precision of a 95% confidence interval surrounding exposure–response relationships depending on the number of investigated subjects and the number of noise events each subject will be exposed to. Functions were fit to the simulation results that can be used by researchers to conveniently power future studies on the effects of aircraft noise on sleep.

Environmental noise and sleep disturbance: Research in central, eastern and south-eastern Europe and newly independent states

Countries from South-East Europe (SEE), Central and Eastern Europe (CEE) and Newly Independent States (NIS) are in the process of harmonization with European environmental noise legislation. However, research work on noise and health was performed in some countries independently of harmonization process of adoption and implementation of legislation for environmental noise. Aim of this review is to summarize available evidence for noise induced sleep disturbance in population of CEE, SEE and NIS countries and to give directions for further research work in this field. After a systematic search through accessible electronic databases, conference proceedings, PhD thesis, national reports and scientific journals in English and non-English language, we decided to include six papers and one PhD thesis in this review: One paper from former Yugoslavia, one paper from Slovakia, one paper from Lithuania, two papers from Serbia and one paper, as also one PhD thesis from The Former Yugoslav Republic of Macedonia. Noise exposure assessment focused on road traffic noise was mainly performed with objective noise measurements, but also with noise mapping in case of Lithuanian study. Sleep disturbance was assessed with the questionnaire based surveys and was assumed from dose-effect relationship between night-time noise indicator (Lnight ) for road traffic noise and sleep disturbance (for Lithuanian study). Although research evidence on noise and sleep disturbance show to be sufficient for establishing dose response curves for sleep disturbance in countries where studies were performed, further research is needed with particular attention to vulnerable groups, other noise sources, development of laboratory research work and common methodology in assessment of burden of diseases from environmental noise.

Focused Study on the Quiet Side Effect in Dwellings Highly Exposed to Road Traffic Noise

This study provides additional evidence for the positive effect of the presence of a quiet façade at a dwelling and aims at unraveling potential mechanisms. Locations with dominant road traffic noise and high Lden-levels at the most exposed façade were selected. Dwellings both with and without a quiet façade were deliberately sought out. Face-to-face questionnaires (N = 100) were taken to study the influence of the presence of a quiet side in relation to noise annoyance and sleep disturbance. As a direct effect, the absence of a quiet façade in the dwelling (approached as a front-back façade noise level difference smaller than 10 dBA) leads to an important increase of at least moderately annoyed people (odds-ratio adjusted for noise sensitivity equals 3.3). In an indirect way, a bedroom located at the quiet side leads to an even stronger reduction of the self-reported noise annoyance (odds-ratio equal to 10.6 when adjusted for noise sensitivity and front façade Lden). The quiet side effect seems to be especially applicable for noise sensitive persons. A bedroom located at the quiet side also reduces noise-induced sleep disturbances. On a loud side, bedroom windows are more often closed, however, conflicting with the preference of dwellers.