White noise intervention at 40-50 dB from 11 p.m. to 6 a.m. for three consecutive nights may increase subjectively assessed sleep quality in ICU patients.
Key Findings
Results
White noise intervention produced significant reductions in total sleep disturbance scores compared to the control group on days 1, 3, and 5.
Intervention group received white noise at 40-50 dB from 11 p.m. to 6 a.m. for three consecutive nights
Control group received routine care without white noise
Significant differences in total sleep scores were observed on days 1, 3, and 5 (p < 0.01)
Comparisons were made using Generalized Estimating Equations (GEE)
Sample size was 58 patients total, with 29 in each group
Results
White noise intervention significantly reduced sleep disturbances in ICU patients on days 1, 3, and 5 compared to the control group.
Sleep disturbances showed greater reductions in the intervention group on days 1, 3, and 5 (p < 0.01)
Sleep disturbances were measured using the Verran and Snyder-Halpern Sleep Scale (VSHSS)
Data were collected at baseline and on days 1, 3, and 5
The study was conducted in a medical center in southern Taiwan between March 2023 and August 2024
Results
Sleep effectiveness was significantly improved in the white noise intervention group on days 3 and 5.
Improved sleep effectiveness was observed on days 3 and 5 (p < 0.01)
No significant difference in sleep effectiveness was reported on day 1
Sleep effectiveness was one of the subscales measured by the VSHSS
The intervention group had an average age of 61.7 ± 13.6 years with 56.9% male participants across both groups
Results
Sleep supplementation scores were significantly increased in the white noise intervention group on day 3.
Increased sleep supplementation score was observed on day 3 (p < 0.01)
Sleep supplementation is a subscale of the VSHSS reflecting compensatory sleep behaviors
Significant differences in sleep supplementation were identified specifically on day 3 but not reported as significant on days 1 or 5
The longitudinal design with block randomization allowed for repeated measurement comparisons
Methods
The study enrolled 58 ICU patients using block randomization in an experimental longitudinal design.
29 patients were assigned to the intervention group and 29 to the control group
Average age of participants was 61.7 ± 13.6 years and 56.9% were male
The study was conducted in a medical center in southern Taiwan from March 2023 to August 2024
Sleep quality was measured using the Verran and Snyder-Halpern Sleep Scale (VSHSS) at baseline and on days 1, 3, and 5
Statistical analysis used Generalized Estimating Equations (GEE) to compare groups over time
What This Means
This research suggests that playing white noise at a moderate volume (40-50 decibels, similar to quiet conversation) through the night in an intensive care unit (ICU) can meaningfully improve sleep quality for patients. In this study conducted in Taiwan, ICU patients who received white noise from 11 p.m. to 6 a.m. for three nights in a row reported less sleep disruption, better overall sleep, and felt more rested compared to patients who received standard care without white noise. These improvements were measured using a validated sleep questionnaire at multiple points over five days.
The ICU is notoriously difficult to sleep in due to constant noise from alarms, equipment, and staff activity. This research suggests that white noise may work by masking these unpredictable environmental sounds, making the background noise more consistent and less disruptive. Benefits were seen as early as the first night and continued through day 5, with some measures like sleep effectiveness showing stronger improvement by days 3 and 5, suggesting the effect may build over time.
This matters because poor sleep in the ICU is associated with worse health outcomes, and white noise is a low-cost, non-drug intervention that could be relatively easy to implement. While the study was small (58 patients total) and relied on patients' self-reported sleep perceptions, the findings add to a growing body of evidence supporting simple environmental modifications to improve ICU patient well-being.
Nien Y, Weng S, Chou P. (2026). The effectiveness of white noise for sleep quality in patients admitted to the intensive care unit: a randomized controlled trial.. Intensive & critical care nursing. https://doi.org/10.1016/j.iccn.2025.104239