Abstract
OBJECTIVE: This study aimed to investigate the effects of white noise therapy combined with cognitive behavioural therapy (CBT) on clinical manifestations, psychological stress and sleep quality in patients with depression. METHODS: This study retrospectively analysed 136 patients with mild to moderate depression treated between January 2022 and December 2024. On the basis of their treatment timeline, the patients were divided into conventional group (n = 47, conventional therapy, January-December 2022), CBT group (n = 45, conventional therapy + personalised CBT, January-December 2023) and white noise group (n = 44, conventional therapy + personalised CBT + white noise therapy, January-December 2024). The clinical symptoms [24-item Hamilton Depression Scale (HAMD-24), Stroop test], psychological stress [Perceived Stress Scale (PSS-10), Gross Emotion Regulation Questionnaire (ERQ)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], cognitive fusion level [Cognitive Fusion Questionnaire (CFQ-F)], hope level [Herth Hope Index (HHI)] and experiential avoidance degree [Acceptance and Action Questionnaire-II (AAQ-II)] were compared before and 12 weeks post-treatment. RESULTS: Compared with pre-therapy levels, statistically significant improvements at 12 weeks were observed for all three groups (P < 0.05). These included reductions in HAMD-24 scores, Stroop mean reaction time, PSS-10 scores, ERQ suppression subscale scores, PSQI scores and AAQ-II scores, along with increases in Stroop correct responses, ERQ reappraisal subscale scores, CFQ-F scores and HHI scores. Post-therapy between-group comparisons revealed that the white noise group exhibited superior outcomes versus both the conventional and CBT groups across all metrics, while the CBT group outperformed the conventional group on all assessment parameters (P < 0.05). CONCLUSION: The findings of this retrospective study suggest that white noise therapy combined with CBT may have positive effects on patients with mild to moderate depression, including improvements in clinical symptoms, psychological stress response and sleep quality. These benefits were demonstrated through reduced depression severity, increased use of cognitive reappraisal strategies, enhanced cognitive fusion, reduced experiential avoidance and elevated hope levels.