A Study on the Correlation between Noise and Sleep Disorders in the Emergency Observation Ward for Elderly Patients

This study aimed to investigate the relationship between objective nighttime noise exposure and sleep quality in elderly patients under emergency observation and to verify whether higher nighttime noise levels are an independent factor contributing to poorer sleep quality after controlling for multiple confounding factors.

The single-center retrospective observational study consecutively enrolled 150 elderly patients (age ≥ 65 years) who were under observation in the emergency department of Zhejiang Sian International Hospital for ≥ 24 h between 31 December 2024 and 31 December 2025. Noise data for the first full night (22:00 to 06:00 the next day) during the observation period were obtained using a fixed automatic environmental noise monitor, with nighttime equivalent sound level (LAeq,8h) as the core exposure indicator. Sleep quality was measured with the Richards-Campbell Sleep Questionnaire (RCSQ), and an RCSQ score < 50 was defined as having a sleep disorder. Covariates included age, sex, disease severity (Modified Early Warning Score, MEWS), pain intensity (Numerical Rating Scale, NRS), anxiety status (Self-Rating Anxiety Scale, SAS), observation duration, and sedative-hypnotic drug use. Pearson correlation analysis was used to examine the relationship between noise and sleep quality, and multiple linear regression analysis was used to adjust for confounding factors and test the independent effect of LAeq,8h on RCSQ score.

Correlation analysis revealed a significant negative association between LAeq,8h and RCSQ score ( r  = -0.431, P < 0.001). After adjusting for all covariates, multiple linear regression confirmed that LAeq,8h remained an independent predictor of a lower RCSQ score (unstandardized B = -0.313, 95% CI: -0.434 to -0.193, standardized β = -0.404, t  = -5.130, P < 0.001). In logistic regression, each 1 dB increase in LAeq,8h was associated with 8% higher odds of sleep disorder (OR = 1.08, 95% CI: 1.03 to 1.13, P  = 0.002).

In elderly patients under emergency observation, higher LAeq,8h is independently associated with poorer sleep quality.