![all night long train all night long train](https://i.ytimg.com/vi/NNOkvxtLIiM/hqdefault.jpg)
3, 4, 6 A Dutch study revealed that the number of persons reporting strong difficulties falling asleep due to traffic noise increased from 18% to 23% between 19. People living close to busy roads and railways or in close proximity to airports therefore often report poor sleep quality. Traffic noise influences sleeping structure 19 and leads to increased awakenings 19, 20 throughout the night. 14 An increased risk for myocardial infarction in persons living close to roads and railways has been found in several studies, 15–18 although the effect sizes are rather small and the effects seem to be more pronounced in men. Babisch summarises that traffic exposure enhances the risk for hypertension by a factor of between 1.5 and 3. 11 Evidence that long-term traffic exposure can increase the risk for cardiovascular disease comes from field studies. 11, 12 Noise-induced HR changes do not seem to habituate during sleep 13 therefore, they might ‘bear a pathogenic potential for the genesis of cardiovascular disease’. This has been shown for pure tones 10 and more recently for traffic noise. 9 External noise events have the potential to disturb sleep and lead to event-related increase of HR. The sympathetic tone is reduced in sleep, which is reflected by a reduction of heart rate (HR). 8 Understanding how railway noise and vibration influence the cardiovascular system in sleep is therefore necessary. Railway noise is related to disturbed sleep, 2–6 which in turn increases the risk of cardiovascular disease, 7 supported by indications of increased cardiovascular disease in persons living close to railways. As the European market share of freight traffic is expected to increase from 8% in 2001 to 15% in 2020, 1 it is important to estimate the impact this may have on the health of persons living close by to railway lines.