Inclusion Criteria:  Adults 18+ Admitted to MUSC's Main Hospital medical intensive care unit (MICU) or Ashley River Tower medical-surgical intensive care unit (MSICU) Intubated and will undergo a spontaneous breathing trial  Exclusion Criteria:  Patients who have had any prior SBTs Patients known to have a neurological injury Patients who are known to be deaf Patients whom (or whose LAR) are unable or unwilling to give informed consent.