Aircraft noise effects on sleep: mechanisms, mitigation and research needs.

There is an ample number of laboratory and field studies which provide sufficient evidence that aircraft noise disturbs sleep and, depending on traffic volume and noise levels, may impair behavior and well-being during the day. Although clinical sleep disorders have been shown to be associated with increased risk of cardiovascular diseases, only little is known about the long-term effects of aircraft noise disturbed sleep on health. National and international laws and guidelines try to limit aircraft noise exposure facilitating active and passive noise control to prevent relevant sleep disturbances and its consequences. Adopting the harmonized indicator of the European Union Directive 2002/49/EC, the WHO Night Noise Guideline for Europe (NNG) defines four Lnight , outside ranges associated with different risk levels of sleep disturbance and other health effects ( < 30, 30-40, 40-55, and> 55 dBA). Although traffic patterns differing in number and noise levels of events that lead to varying degrees of sleep disturbance may result in the same Lnight , simulations of nights with up to 200 aircraft noise events per night nicely corroborate expert opinion guidelines formulated in WHO's NNG. In the future, large scale field studies on the effects of nocturnal (aircraft) noise on sleep are needed. They should involve representative samples of the population including vulnerable groups like children and chronically ill subjects. Optimally, these studies are prospective in nature and examine the long-term consequences of noise-induced sleep disturbances. Furthermore, epidemiological case-control studies on the association of nocturnal (aircraft) noise exposure and cardiovascular disease are needed. Despite the existing gaps in knowledge on long-term health effects, sufficient data are available for defining limit values, guidelines and protection concepts, which should be updated with the availability of new data.