Medge Doffay has lived in the shadow of London's Heathrow Airport for more than three decades but the constant presence of planes overhead, sometimes as frequent as one every 40 seconds, grates on a daily basis. Ms Doffay, who is retired, says you can never truly get over the noise, which can make the buildings on her street shake. She sleeps downstairs and worries the disruption will give her a stroke. The daily challenge of a restful sleep is something that will be understood by anyone living next door to an airport or under a flight path. But aside from being <a href="https://www.thenationalnews.com/world/uk-news/2023/06/21/heathrow-study-highlights-heart-risk-of-living-near-an-airport/" target="_blank">nuisance noise</a>, one of the largest studies conducted into its impact on sleep has revealed how it is linked with disturbed sleep quality and sleep-wake cycles, regardless of how long you slumber for. Previously shrugged off as a repetitive annoyance, the persistent <a href="https://www.thenationalnews.com/uae/transport/as-airport-noise-rattles-mirdif-homes-residents-admit-you-get-used-to-it-1.489262" target="_blank">dull growl</a> has now been proven to disrupt sleep – even if you had a full night’s sleep and did not realise it – with fears it could result in long-term health implications. The study has found that aircraft noise at night can disrupt sleep by evoking physiological signals in the auditory system, because the sleeping body continues to react to environmental stimuli, even without people realising. "This disruption potentially results in shortened sleep, sleep awakenings, stage modifications and autonomic responses," the research report from the University of Leicester said. "The relationship between sleep and health conditions is complex. Poor sleep can be associated with higher blood pressure, mental health, as well as neurological conditions. There is a bidirectional relationship between sleep and diabetes. Poor sleep can be linked to a higher risk of developing Type 2 diabetes." Campaigners have worked hard to achieve some respite for residents but want longer periods of silence with tighter restrictions on night flights. For the residents of Myrtle Avenue, in Feltham, west London, like Ms Doffay, this would be a blessing. It is one of the noisiest streets in the country for aircraft just metres from Heathrow's runway - the planes fly so low it has even made it a popular spot for plane spotters. "When landing, the noise is low but when taking off it is so noisy that we have to close all the doors and windows," she told <i>The National</i> from her front doorstep on the street of 1930s semi-detached and terraced homes. "Once upon a time we could go in the kitchen and it was not too bad but now it is very annoying. Sometimes I do not know what I am going to do with the noise. I'll have a stroke, probably. "They fly up until 11pm. But sometimes up to midnight. But you can still hear the noise from the planes in the airport in the middle of the night. There was a time that I couldn’t sleep with that noise, even now I sleep downstairs. Sometimes it makes your life a bit sad. I think of selling." The room above her neighbour Mahd Kurd shakes when the planes pass overhead. But he still dreams of becoming a pilot. “They do not really bother me," he said of the planes. "I quite like it here, I look out the window at the airport and it is a beautiful view. I’m a heavy sleeper so they do not really affect me.” Still on the flight path, but on the other side of London, one resident in East Dulwich told researchers the aircraft noise at night was like a “low growl” and said he felt like he was in a “constant thunderstorm”. Another in the area said: “I would be woken up most mornings by the sound of the first planes coming in from Asia around 4.30am. I became quite anxious, as the harder I would try to go to sleep and to ignore the plane noise, the more awake I would become. “I remember trying to get back to sleep after a plane passed, getting almost there and then feeling defeated as I could hear the very faint whine of the next plane approaching.” In the largest study of the effect of aircraft noise on sleep yet conducted, researchers from the University of Leicester found people exposed to higher levels of night-time jets flying overhead experienced more restlessness during sleep and disruption in daily sleep rhythm, even if they had a full night’s sleep. For Paul Beckford, from the Heathrow Association for the Control of Aircraft Noise, and his members, the findings are all too familiar. “It is a big problem,” he told <i>The National</i>. “The planes start at 6am, sometimes as early as 4am, and lots of people get woken up and then struggle to get back to sleep, and it then impacts their productiveness during the day." He said rules allow planes to fly later if they are disrupted by weather, or other delays, so they could still be arriving at 2am. “It can be a trigger for mental health conditions because people are expecting to be woken up and it impacts stress levels," he said. He is pleased the study has recognised a link between plane noise and ill health. Environmental health experts at the University of Leicester used movement trackers and self-reported sleep information to put together a more detailed picture of the link. “Our study suggests that night-time aircraft noise was associated with more restless sleep and disrupted sleep-wake cycles, suggestive of a link between night-time aircraft noise exposure and sleep disturbance,” lead author Xiangpu Gong said. “Poorer sleep patterns, as measured by actimetry, have been associated with higher risk of mental health problems, conditions like diabetes and obesity, and with mortality risk. “The key message for the public is that higher night-time aircraft noise was linked with disturbed sleep quality, even if people didn’t realise it. Sleep disturbance could have long-term effects on health, so it’s important for policies to address and reduce noise pollution from planes.” Researchers used the UK Biobank cohort study, originally set up to examine links between genes and disease, to identify and analyse data from more than 80,000 people living near four major airports – London Heathrow, London Gatwick, Manchester and Birmingham. To measure sleep, the researchers used wearable devices, similar in size to a watch, that tracked movement during sleep, a method called actimetry, for about 20 per cent of the participants between 2013 and 2015. Alongside this, they used responses to questionnaires collated between 2006 and 2013, in which people reported on their sleep quality, how long they slept and whether they took daytime naps. The aircraft noise each person was exposed to was estimated using noise maps created by the UK Civil Aviation Authority. The maps showed how loud the aircraft noise was (in decibels, dB) in 2011 in areas near the airports and this was matched to where the participants lived. The sleep of those exposed to higher noise levels, defined as a night-time average of 55dB or more, was compared with those exposed to fewer than 45dB. Anna Hansell, professor of environmental epidemiology at the University of Leicester, said the results were concerning. “This study is different because it is one of the largest on this topic and combined sleep data from wearable devices with self-reported sleep information. Most previous studies have relied on people’s self-reports about their sleep, which can sometimes be inaccurate due to poor recall,” she said. “In contrast, actimetry, which uses devices to track sleep, doesn’t require people to remember how they slept, hence providing a more objective measure of sleep. “Interestingly, while we found evidence that night-time aircraft noise was linked to poorer sleep – more movement and disrupted sleep-wake cycles – the length of time people slept did not appear to be affected." The researchers said their results have "significant policy implications" and highlight the necessity for authorities to formulate strategies that mitigate sleep disturbances caused by aircraft noise. Mr Beckford hopes the study will help lead to stronger regulation. “We continually need more evidence to show the health impact. It shows that even if people are not waking up, their sleep is still being disturbed,” he said. In 2018, the World Health Organisation recommended reducing the noise levels produced by aircraft during night-time to below 40dB between 11pm to 7am because such noise above this level is associated with adverse effects on sleep. Tim Johnson, from the Aviation Environment Federation, said there have been repeated calls for night-time curfews. “Overflown communities will be all too familiar with the impacts recognised in this study," he told <i>The National. </i>“Aircraft noise affects around a million people in the UK and this study adds to the evidence that shows how it can negatively impact on public health. While airports often have night noise restrictions, there are still a significant number of take-offs and landings when most people are trying to sleep. “In response, communities are calling for airports to ensure that they meet the World Health Organisation's guidelines on community noise exposure, or if they cannot, to impose a curfew during the night period.” For Ms Doffay, she would just like a day off from the noise. "Every 10 years the airport sends someone to replace the windows and doors, but this time I can still hear the noise. You can still hear it inside no matter where you are in the house," she said. "On a Sunday I would just like to sit in the garden, but I can't. All I ask is, I know you are flying every day, but sometimes just give us a break. Just one day off every two weeks would be nice."