Hospital Noise and Post-Stroke Sleep Disorders: A Review of Mechanisms and Management Strategies

Hospital noise is a pervasive environmental stressor that may adversely affect sleep quality and neurological recovery of post-stroke patients. Although the World Health Organization has established recommended limits for hospital noise levels, real-world conditions frequently exceed these limits, with the issue being particularly pronounced in stroke wards due to noise generated by medical equipment and staff activity. The incidence of post-stroke sleep disorders is notably high. Noise disrupts sleep architecture through pathophysiological mechanisms, including activation of the auditory pathway and cortical arousal, induction of stress responses and neuroendocrine dysregulation, and increased cardiovascular burden. These detrimental effects are further amplified by the heightened vulnerability resulting from post-stroke brain injury. Clinical evidence indicates a dose-response relationship between hospital noise levels and impaired subjective sleep quality and sleep efficiency. Furthermore, noise has been associated with delayed motor and cognitive functions and exacerbates mood disorders. Effective management strategies require systematic, multifaceted interventions, encompassing engineering and administrative modifications at the noise source, along with patient-centered protective measures and sound-masking therapies. However, challenges such as the complexity of hospital noise, individual patient differences, and implementation compliance persist, and high-quality research in this area remains insufficient. Future efforts should focus on developing intelligent monitoring systems, conducting research on personalized clinical pathways, and integrating noise management throughout the stroke rehabilitation process to establish an optimal acoustic environment conducive to neurological recovery.