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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Too noisy, too dark: sleep environment at a typical stroke unit.

Noel Schuerch1,2, Claudio L A Bassetti1,2, Marcel Arnold1

  • 1Department of Neurology, Inselspital University Hospital Bern, Bern 3010, Switzerland.

European Stroke Journal
|April 14, 2026
PubMed
Summary

Hospital stroke units exceed recommended noise and light levels, negatively impacting patient sleep. These environmental factors may hinder recovery and worsen stroke outcomes.

Keywords:
circadian rhythmenvironmental exposurelightnoisesleep–wake disordersstroke

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Area of Science:

  • Neurology
  • Environmental Health
  • Sleep Medicine

Background:

  • Sleep-wake disorders are prevalent post-stroke, adversely affecting patient outcomes.
  • Environmental factors like noise and light significantly disrupt sleep quality and circadian rhythms in stroke patients.
  • Hospital environments, particularly stroke units, require assessment for factors impacting sleep.

Purpose of the Study:

  • To quantify noise and light exposure in a hospital stroke unit.
  • To evaluate compliance with World Health Organization (WHO) recommended environmental guidelines for patient care.
  • To identify specific environmental stressors affecting sleep in stroke patients.

Main Methods:

  • Noise levels were measured using equivalent continuous A-weighted sound pressure level (LAeq).
  • Light exposure was assessed using melanopic equivalent daylight illuminance.
  • Measurements were conducted in a stroke unit between July and August 2021.

Main Results:

  • WHO-recommended noise levels were consistently exceeded, with door beds being significantly noisier than window beds.
  • Minimal daytime illuminance levels were rarely achieved, especially at door beds.
  • Optimal light levels were observed in the evenings, not during the morning hours crucial for circadian alignment.

Conclusions:

  • The monitored stroke unit environment is suboptimal for patient sleep due to excessive noise and insufficient light.
  • These environmental conditions may negatively influence sleep-wake regulation and overall stroke recovery.
  • Further research is warranted to confirm these findings and explore interventions to improve the hospital environment for stroke patients.