Postoperative sleep quality in urological patients requires improvement and is significantly correlated with ward noise exposure, with noise exposure being the strongest independent predictor of poor sleep quality.
Key Findings
Results
The majority of postoperative urological patients experienced poor sleep quality, with 82 of 182 patients (45%) categorized in the poor sleep quality group.
182 total patients were analyzed from a retrospective cohort study conducted between January 2021 and December 2024
Patients were stratified using the Athens Insomnia Scale (AIS): poor sleep quality (PSQ) defined as AIS > 6, good sleep quality (GSQ) defined as AIS ≤ 6
82 patients were in the PSQ group and 100 patients were in the GSQ group
The overall mean AIS score was 6.74 ± 1.65
Results
Ward noise exposure levels in the urological ward exceeded typical recommended hospital noise limits, with a mean of 61.55 dB.
The overall mean ward noise exposure level was 61.55 ± 7.75 dB
The PSQ group showed significantly higher noise exposure levels than the GSQ group (P < 0.05)
Noise exposure was identified as the strongest independent predictor of poor sleep quality among all variables tested
Results
A significant positive correlation existed between AIS score and ward noise exposure levels.
Pearson's correlation analysis was used to assess the relationship between sleep quality and noise exposure
The correlation coefficient r > 0, indicating a positive relationship between noise levels and AIS scores
The correlation was statistically significant at P < 0.001
Results
Multivariate logistic regression identified five significant independent predictors of poor postoperative sleep quality.
The five significant predictors were: age, IV-PCA retention, postoperative length of stay (PLOS), anxiety/depression score, and noise exposure
All predictors had OR > 1 and P < 0.05, indicating each was associated with increased odds of poor sleep quality
Noise exposure was the strongest independent predictor among the five identified factors
No other baseline characteristics differed significantly between the two groups
Results
Patients not placed on intravenous patient-controlled analgesia (IV-PCA) catheters had significantly worse sleep quality.
The PSQ group showed significantly higher rates of not having IV-PCA catheters placed compared to the GSQ group (P < 0.05)
IV-PCA retention was confirmed as a significant predictor of sleep quality in multivariate logistic regression (OR > 1, P < 0.05)
This suggests adequate postoperative pain management via IV-PCA may be protective against poor sleep
Results
Older age, longer postoperative length of stay, and higher anxiety/depression scores were each significantly associated with poor sleep quality.
The PSQ group showed significantly higher age compared to the GSQ group (P < 0.05)
The PSQ group showed significantly longer postoperative length of stay (PLOS) than the GSQ group (P < 0.05)
The PSQ group showed significantly higher anxiety/depression scores than the GSQ group (P < 0.05)
All three variables were confirmed as independent predictors in multivariate logistic regression (OR > 1, P < 0.05)
What This Means
This research suggests that poor sleep is common after urological surgery, with nearly half of the 182 patients studied experiencing poor sleep quality based on the Athens Insomnia Scale. The study was conducted at a hospital in China and looked back at patient records from 2021 to 2024, comparing patients with good and poor sleep to identify what factors made a difference. The average noise level in the wards was measured at about 61.5 decibels — roughly equivalent to the noise level of a normal conversation or background restaurant noise — which exceeds typical recommended hospital nighttime noise limits.
The study found that ward noise was the single strongest factor predicting whether a patient would sleep poorly after surgery, and that worse sleep was directly linked to higher noise levels. Other important factors included older age, not having a patient-controlled pain pump (IV-PCA), longer hospital stays after surgery, and higher levels of anxiety or depression. This research suggests that managing ward noise is particularly important for helping surgical patients recover well, as poor sleep can delay healing and worsen patient outcomes.
Practically, these findings point to noise reduction in hospital wards as a meaningful target for improving postoperative recovery. The research also highlights that pain management tools like IV-PCA and attention to patients' mental health — particularly anxiety and depression — may help improve sleep after urological surgery. Because this was a retrospective study from a single hospital, further research across different settings would help confirm these findings.
Shen J, Xie X, Zhang K, Mu Y. (2026). Factors Influencing Sleep Quality in Postoperative Urological Patients and its Correlation with Ward Noise Exposure Levels.. Noise & health. https://doi.org/10.4103/nah.nah_125_25