Night-time Noise Levels and Patients’ Sleep Experiences in a Medical Assessment Unit in Northern England

Nurses' Perspectives on the Sleep Quality of Hospitalized Patients in Al Ahsa, Saudi Arabia

BACKGROUND

Sleep quality is crucial for patient recovery and well-being, yet hospitalized patients often suffer from poor sleep due to environmental disruptions, clinical routines, and psychosocial stressors. While these challenges are well-documented, qualitative insights into nurses' perspectives-essential frontline providers shaping the sleep environment-are scarce, especially within rapidly evolving healthcare systems like Saudi Arabia's. This study explores nurses' perceptions of factors influencing patient sleep quality in a private hospital in Al Ahsa, Saudi Arabia, and identifies strategies for improvement.

METHODS

We conducted a qualitative, cross-sectional study using semi-structured interviews with 14 registered nurses from diverse nationalities, specialties (Obstetrics/Gynecology, Medical-Surgical, Pediatrics, Intensive Care, Orthopedics, Bariatrics), and experience levels. Interviews were conducted in Arabic or English, audio-recorded, transcribed, and thematically analyzed using ATLAS.ti software. Roy's Adaptation Model guided the examination of environmental, patient-specific, and systemic factors affecting sleep.

FINDINGS

Four primary themes emerged: (1). Environmental Factors: noise from alarms, equipment, family presence, and late-night activities, along with abrupt lighting changes, consistently disrupted sleep. (2). Patient-Specific Factors: pain, emotional distress, cultural expectations, and family involvement influenced sleep experiences. (3). Systemic and Contextual Factors: language barriers, infrastructural disparities between private and governmental hospitals, and limited resources can impeded effective sleep-promoting strategies. (4). Role of Health Technology: nurses recognized the potential of innovations like smart lighting and wearable monitors to enhance sleep quality but faced challenges in implementation due to knowledge gaps and limited familiarity. Roy's Adaptation Model highlighted how effective adaptation through physiological and cognitive-emotional pathways, as observed by nurses, was facilitated or hindered by these factors.

CONCLUSIONS

Enhancing in-hospital sleep quality requires a holistic, culturally sensitive approach that integrates environmental modifications, patient-centered care, and systemic improvements. Strategic investments in staff communication training, infrastructural upgrades, language support services, and the adoption of health technologies can promote adaptive responses and optimize patient rest. By leveraging theory-driven insights and context-specific strategies, healthcare systems-particularly those undergoing rapid development-can better support nurses in fostering restorative sleep environments as a fundamental component of patient-centered care, thereby enhancing patient recovery, satisfaction, and overall well-being.

Effects of Ward Night Noise Management in the Context of Enhanced Recovery After Surgery on Postoperative Sleep Quality, Anxiety, and Hormone Levels of Thoracic Surgery Patients with Lung Cancer

OBJECTIVE

This study aimed to analyze the effects of ward night noise management in the context of enhanced recovery after surgery (ERAS) on postoperative sleep quality and anxiety of thoracic surgery patients with lung cancer.

METHODS

This retrospective analysis included 118 patients with lung cancer who underwent thoracic surgery (from January 2020 to December 2021). The patients were categorized into the control and observation groups, which comprised 63 and 55 cases, respectively, on the basis of perioperative management plans. The two groups were compared in terms of their score in Athens Insomnia Scale (AIS), the State-Trait Anxiety Inventory (STAI) and Self-Rating Depression Scale (SDS), salivary cortisol (SC), thyroid hormone (TSH), and angiotensin II (Ang II) levels, and noise measurements at various timepoints.

RESULTS

The observation group exhibited a significantly lower noise level than the control group (P < 0.001). No statistically significant difference was found in the AIS, STAI, and SDS scores and Ang II, TSH and SC levels between the two groups before their surgery (P > 0.05). Compared with the control group, the observation group achieved significantly lower AIS scores at 1, 3 and 7 days after surgery (P < 0.05) and significantly lower STAI scores at 1 and 3 days postsurgery (P < 0.05). Significantly lower Ang II, TSH and SC indices were observed in the observation group after management than the control group (P < 0.05).

CONCLUSION

Night noise management in the context of ERAS can improve sleep quality and adverse moods of patients who underwent thoracic surgery for lung cancer, which helps in the promotion of prognosis.

Effectiveness of Earplugs and Eye Masks on Sleep Quality and Fatigue Among Nonventilated Patients in an Intensive Care Unit

BACKGROUND

Sleep is a basic physiological need and is imperative for healing and rejuvenation. However, the environment of the intensive care unit (ICU), including loud sounds and bright lights, can undermine patients' sleep quality.

AIM

This study was designed to determine the effectiveness of overnight use of earplugs and eye masks to improve sleep quality and potentially influence hemodynamic parameters and mitigate fatigue among nonventilated patients in an ICU.

MATERIALS AND METHODS

This experimental study was conducted among 84 nonventilated patients in an ICU. The patients were evenly divided between an intervention group (n=42) and a control group (n=42). The intervention group patients received earplugs and eye masks for three consecutive nights from 10:30 pm to 6:30 am, while the control group patients received routine care. Clinical data, responses to the Richards-Campbell sleep questionnaire, and rankings on a numerical fatigue scale were collected before (pretest) and after the intervention each night and the next morning (posttests 1, 2, and 3).

RESULTS

The results revealed a significant reduction in fatigue. At pretest, fatigue scores in the study group were 4.19±1.64. The score was significantly reduced to 3.40±1.39 at posttest 1 and then to 2.21±1.00 at posttest 3 (p<0.0001). The sleep quality for the study group showed a significant improvement from the pretest score of 43.73±8.27 to 60.35±6.85 at posttest 3 (p<0.001), whereas the control group had slightly worse sleep quality, with 40.64±8.67 at pretest and 45.63±6.95 at posttest 3.

CONCLUSIONS

Continuous patient monitoring is an essential nursing care activity in ICUs while ensuring good-quality sleep promotes healing and reduces fatigue. Sleep quality can be supported by devices such as earplugs and eye masks to limit undue disturbances in the ICU settings.

Parents' Experiences and Perspectives of Their Child's Sleep Quality During Hospitalization

Sleep is essential for maintenance and restoration of health, yet studies exploring this in hospitalized children are scarce. In a qualitative study, we assessed the perceived quality of sleep, factors affecting sleep, and the role of health care professionals in the sleep environment for hospitalized children aged 1 to 12 years. Data were obtained from 11 semi-structured, audio-recorded, and verbatim-transcribed interviews with parents, and analyzed using a systematic thematic analysis. The interviews were coded based on iterative assessment of transcripts. Subsequently, categories and interpretative main themes were identified. Four themes emerged: (1) being informed, keeping informed; (2) coordination of care; (3) parents as main advocates for their child's sleep; and (4) environmental disturbers. Parents reported differences in their child's sleep quality during hospital compared with home. Sleep is substantially affected during hospitalization, prompting the need for interventions to improve the quality of sleep of children. Parents provided valuable suggestions for improvements.

Analysis of the Acoustic Comfort in Hospital: The Case of Maternity Rooms

Hospitals include a variety of different spaces with different requirements and levels of sensitivity to noise but also different activities and equipment that can cause high noise levels. In this article, noise disturbance in hospitals is studied with reference to a case study in a maternity ward. The analysis is carried out by means of sound insulation measurements between bedrooms and between bedroom and corridor. Equivalent sound pressure level measurements were carried out continuously for two days and nights. The number of awakening events is examined for each hour of the two nights. In addition, the results of a questionnaire conducted on more than 100 patients are reported. The results of the study show that the main cause of noise disturbance is activity in the corridors and that this kind of disturbance is usually repeated throughout the night. This is made more critical by the poor acoustic performance of the doors, but also by the habit of keeping doors open or half-open to allow doctors to always control patients. The article proposes some possible solutions to reduce noise intrusion from the corridor to the rooms.

Environmental noise in hospitals: a systematic review

Environmental noise has been growing in recent years, causing numerous health problems. Highly sensitive environments such as hospitals deserve special attention, since noise can aggravate patients' health issues and impair the performance of healthcare professionals. This work consists of a systematic review of scientific articles describing environmental noise measurements taken in hospitals between the years 2015 and 2020. The researchers started with a consultation of three databases, namely, Scopus, Web of Science, and ScienceDirect. The results indicate that for the most part, these studies are published in journals in the fields of medicine, engineering, environmental sciences, acoustics, and nursing and that most of their authors work in the fields of architecture, engineering, medicine, and nursing. These studies, which are concentrated in Europe, the Americas, and Asia, use as reference values sound levels recommended by the World Health Organization. L_eq measured in hospital environments showed daytime values ranging from 37 to 88.6 dB (A) and nighttime values of 38.7 to 68.8 dB (A). L_eq values for outdoor noise were 74.3 and 56.6 dB (A) for daytime and nighttime, respectively. The measurements were taken mainly inside hospitals, prioritizing more sensitive departments such as intensive care units. There is a potential for growth in work carried out in this area, but research should also include discussions about guidelines for improvement measures aimed at reducing noise in hospitals.