The Effect of Ward Level Noise On Anxiety and Sleep In An Inpatient Population Aged Greater Than 65 Years Old

Background The term “noise” is derived from the Latin word noxia, meaning “injury”. Excessive noise can negatively affect inpatients, particularly those aged over 65 by increasing stress, disrupting sleep, inducing delirium and prolonging hospital length of stay (LOS). Although the World Health Organization recommends maintaining hospital noise levels between 30-40dB, this is frequently exceeded in inpatient settings. Methods This study assessed the impact of ward level noise (WLN) on self-reported anxiety and sleep disturbance among inpatients aged over 65 in two settings: an acute model 4 hospital in an urban area and a rehabilitation ward in a model 2 hospital in a suburban area. Patients were interviewed using a two-part questionnaire, consisting of: (1) the Hospital Anxiety and Depression Scale (HADS) and (2) a four-part structured self-reported questionnaire developed by the authors. Results Twenty-eight inpatients were interviewed: 19 from the acute hospital (AH) and 9 from the rehabilitation ward (RW). Patients’ average age was 81 (range: 70-95 years, SD = 6.5), including 15 females. Four had a history of anxiety or depression and seven were on antidepressant or anxiolytic treatment. Average length of stay: 14.1 days in AH versus 52.3 days in RW. In AH 53% (10/19) reported sleep disturbance due to WLN versus 0% in RW (p<0.01). The average HADS anxiety score was higher in AH than in RW (6.6 versus 5.4, p=0.37). Conclusion Inpatients in the acute hospital reported more sleep disturbances and trend to higher average HADS scores associated with WLN compared to those in the rehabilitation ward. WLN has the potential to increase anxiety and disrupt sleep in inpatients over the age of 65. Further large-scale research is recommended to explore environmental improvements and noise reduction strategies, such as sound-absorbing materials and designated quiet hours, which could enhance patient care and wellbeing.