Association between Nocturnal Environmental Noise and Sleep Quality in Hospitalised COPD Patients: A Retrospective...

This study aimed to analyse the influence of nocturnal environmental noise levels on sleep quality and the frequency of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD).

A retrospective cohort study was conducted by reviewing the clinical data of 120 patients with COPD admitted to Central Hospital Affiliated to Shandong First Medical University between January 2022 and December 2024. Patients were categorised into a poor sleep quality group (Athens Insomnia Scale [AIS] score >6) and a good sleep quality group (AIS score ≤6) based on their mean AIS scores. Nocturnal environmental noise levels, polysomnography (PSG) parameters and acute exacerbation frequency were compared between the two groups. Univariate analysis was employed to screen variables ( P < 0.1), which were subsequently incorporated into multivariate logistic regression models and Pearson correlation analysis to investigate the influence of noise levels on sleep quality and acute exacerbation frequency.

Compared with the good sleep quality group ( n  = 70), the poor sleep quality group ( n  = 50) had significantly higher nocturnal noise levels ( P < 0.05) and worse PSG parameters, including reduced total sleep time; efficiency and N2/N3 sleep and increased sleep latency, N1 sleep and awakenings (all P < 0.05). No significant inter-group differences were found in demographics or exacerbation frequency. Multivariate analysis identified nocturnal noise level as an independent risk factor for poor sleep quality [odds ratio (OR) = 3.012 per 5 dB increase; 95% confidence interval (CI): 1.650-5.611, P < 0.001]. Noise levels were negatively correlated with restorative sleep measures and positively correlated with sleep fragmentation indicators (all P < 0.05) but showed no association with acute exacerbation frequency.

Nocturnal environmental noise is an independent risk factor for impaired sleep quality in hospitalised patients with COPD, but it is not associated with short-term exacerbation frequency. Interventions aimed to reduce ward noise at night may improve sleep quality in this population.