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Nighttime low-frequency noise in the ICU is associated with sleep structure disturbance and increased delirium risk in patients with multiple organ dysfunction syndrome

In a study of 172 MODS patients, 72-h LAeq was highest in the low-frequency band, and delirium incidence was 47.67%. Nighttime low-frequency noise was positively correlated with sleep latency and awakenings, and negatively correlated with slow-wave sleep and REM sleep proportions. Multivariate logistic regression identified elevated nighttime low-frequency noise and decreased SWS and REM proportions as independent risk factors for delirium.

Last updated: Jul 25, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Association of Intensive Care Unit Noise Spectrum with Delirium and Sleep Structure Disturbance in Patients with Multiple Organ Dysfunction Syndrome.

observational

Jin B, Liu M, Wang Y · Noise & health (2026)

Participants: N/A
Duration: 72 hours of noise monitoring; 7 days for delirium assessment
Intervention: Continuous environmental noise monitoring with spectrum analyzer; comparison of noise levels between delirium and non-delirium groups
Outcome: Delirium incidence (CAM-ICU), sleep structure parameters (sleep latency, awakenings, SWS proportion, REM proportion)
Effect Size: N/A
Population: 172 patients with multiple organ dysfunction syndrome admitted to Zhoushan Hospital ICU from January 2021 to September 2025

Result:

PubMed: 42446331DOI: 10.4103/nah.nah_59_26

Mechanism Graph

Nighttime low-frequency noise exposure in ICU
↓
Disruption of sleep structure (increased sleep latency and awakenings, decreased SWS and REM)
↓
Altered brain recovery and neuroinflammation
↓
Increased risk of delirium

Limitations

  • ⚠Single-center study design may limit generalizability
  • ⚠Observational nature cannot establish causality between noise and delirium

Frequently Asked Questions

What noise frequency band was most strongly associated with delirium?▼

Low-frequency noise, particularly at nighttime, showed the strongest association with delirium and sleep disturbance.

How was delirium assessed in this study?▼

Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU) within 7 days of admission.

Did the study find any protective sleep factors?▼

Higher proportions of slow-wave sleep and REM sleep were associated with lower delirium risk.

What were the noise levels compared to WHO limits?▼

Daytime and nighttime LAeq exceeded World Health Organization limits for noise in hospital environments.

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References

  1. 1.Jin B, Liu M, Wang Y. "Association of Intensive Care Unit Noise Spectrum with Delirium and Sleep Structure Disturbance in Patients with Multiple Organ Dysfunction Syndrome.." Noise & health, 2026. PMID: 42446331 DOI: 10.4103/nah.nah_59_26
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.