Abstract
PURPOSE: This study aimed to assess the levels and sources of noise in the emergency intensive care unit (EICU) of an emergency department and investigate their effects on the sleep quality of conscious patients. METHODS: A study was conducted on patients admitted to the EICU from December 2020 to December 2023. They were categorised according to their sleep quality with the Pittsburgh Sleep Quality Index. Environmental noise levels were measured using precision sound level metres and environmental noise automatic monitoring instruments. Data analysis was performed using SPSS version 25.0, and Chi-square test, Fisher's exact probability and t-tests were conducted when applicable. The significance threshold was set at P < 0.05. Regression analysis was carried out for indicators with significant differences. RESULTS: A total of 200 patients were included in the study. Of them 96 in the ideal sleep group and 104 in the non-ideal sleep group. Patients with non-ideal sleep experienced significantly higher noise levels across various measures (P < 0.05). Additionally, patients with non-ideal sleep reported significantly higher occurrences of noise-related awakening, difficulty in falling asleep, nightmares or vivid dreams and sleepwalking episodes (P < 0.05). Significant differences in staff activities, including staff conversations, equipment noise exposure, cleaning activities, patient interventions and overhead pages, were observed between the groups (P < 0.05). Multivariate logistic regression analysis indicating that the average noise level, conversational speech, equipment alarms, ambient noise, peak noise levels, staff conversations, cleaning activities, patient interventions and overhead pages were significant contributors to poor sleep. CONCLUSION: The study suggested that high noise levels and staff-related activities affected the sleep quality of conscious patients in the EICU. Targeted measures could improve the prognoses of patients.