Comparative Effects of Music Therapy Versus White Noise on Sleep Quality and Psychological Resilience of Night-Shift Nurses: Retrospective Cohort Study.
White noise demonstrates greater efficacy for sleep quality and circadian rhythm optimisation, while music therapy provides superior psychological resilience enhancement, burnout reduction and emotional labour management in night-shift nurses.
Key Findings
Results
The white noise group demonstrated significantly lower PSQI scores compared with the music group at 4-week post-implementation, indicating better sleep quality.
Participants were night-shift nurses enrolled in hospital-based health management programs between April 2024 and April 2025
Music group (n=52) received music-based care from April 2024 to September 2024; white noise group (n=48) underwent white noise exposure from October 2024 to April 2025
Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI)
Difference was statistically significant at P < 0.05
Effect sizes were quantified using Cohen's d
Results
The white noise group showed significantly higher CTI-11 Flexibility/Rigidity (FR) subscale scores, indicating greater circadian flexibility compared with the music group.
Circadian flexibility was assessed using the Circadian Type Inventory-11 (CTI-11) with Flexibility/Rigidity (FR) and Languidness/Vigorousness (LV) subscales
Higher FR subscale scores in the white noise group were statistically significant at P < 0.05
The white noise group also had significantly lower CTI-11 LV subscale scores compared with the music group (P < 0.05)
Lower LV scores suggest reduced languidness or greater vigorousness in the white noise group
Results
The music group demonstrated significantly higher CD-RISC-10 scores compared with the white noise group, indicating superior psychological resilience enhancement.
Psychological resilience was measured using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10)
The white noise group had significantly lower CD-RISC-10 scores compared with the music group at 4-week post-implementation (P < 0.05)
This finding suggests music therapy provides superior psychological resilience enhancement over white noise exposure
Results
The white noise group had significantly higher MBI-GS scores compared with the music group, indicating greater occupational burnout in the white noise group.
Occupational burnout was assessed using the Maslach Burnout Inventory-General Survey (MBI-GS)
Higher MBI-GS scores in the white noise group were statistically significant at P < 0.05
This result suggests music therapy provides superior burnout reduction compared to white noise exposure
Results
The white noise group showed significantly lower genuine emotion expression dimension scores on the Emotional Labor Scale compared with the music group.
Emotional labour management was assessed using the Emotional Labor Scale (ELS)
The white noise group had significantly lower genuine emotion expression dimension scores (P < 0.05)
Conversely, the white noise group had significantly higher surface acting plus deep acting dimension scores on the ELS compared with the music group (P < 0.05)
These findings suggest music therapy is superior for emotional labour management, particularly in supporting genuine emotion expression
Conclusions
Both music therapy and white noise exposure effectively enhanced sleep quality, circadian adaptability, psychological resilience, occupational burnout recovery, and emotional labour regulation in night-shift nurses.
The study used a quasi-experimental retrospective design with 100 total participants
Assessments were conducted before the program and at 4-week post-implementation
Both interventions were delivered as part of hospital-based health management programs
An independent sample t-test was used to compare differences between groups
What This Means
This research suggests that both music therapy and white noise can help night-shift nurses sleep better and cope with the psychological demands of shift work, but that each approach has different strengths. In a study of 100 nurses, those who were exposed to white noise showed better sleep quality and more flexible circadian (body clock) rhythms after four weeks, while those who received music therapy showed higher psychological resilience, less occupational burnout, and healthier emotional coping strategies.
The study found that white noise appeared more effective at addressing the physical side of shift work challenges—specifically improving sleep and helping the body's internal clock adapt—while music therapy was more effective at addressing the psychological and emotional dimensions, including reducing burnout and helping nurses express genuine emotions rather than relying on surface-level emotional masking. Both interventions were delivered as part of structured hospital health management programs over several months.
This research suggests that healthcare institutions might consider tailoring wellness interventions for night-shift workers based on their most pressing needs: white noise for those primarily struggling with sleep disruption, and music therapy for those dealing more heavily with psychological stress and emotional exhaustion. However, the study's retrospective design and the fact that the two groups were enrolled in different time periods (rather than simultaneously) are important limitations to keep in mind when interpreting these findings.
Zhang W, Li Y, Li F. (2026). Comparative Effects of Music Therapy Versus White Noise on Sleep Quality and Psychological Resilience of Night-Shift Nurses: Retrospective Cohort Study.. Noise & health. https://doi.org/10.4103/nah.nah_132_25