Abstract:

Objective To systematically evaluate the effect of white noise on sleep quality of ICU patients by meta-analysis. Methods The studies on the effects of white noise on sleep quality in critically ill patients were searched by computer from 11 databases，including CINAHL and PubMed. The search limit was from the inception of the database to March 11，2024. Two researchers independently screened literature，extracted data and assessed the risk of bias. RevMan 5.4 software was used for meta-analysis. Results A total of 9 studies involving 792 subjects were included in the study. The results of meta-analysis showed that white noise could improve sleep in ICU patients[MD=-4.63，95%CI（-7.11，-2.14），P<0.001]，accelerate the speed of falling asleep[MD=21.82，95%CI（8.14，35.50），P<0.001]，and improve sleep depth[MD=19.18，95%CI（7.05，31.31），P<0.001]，reduce the number of nocturnal awakenings[MD=20.36，95%CI（6.46，34.26），P<0.001]，accelerate re-falling asleep[MD=23.72，95%CI（9.22， 38.22），P<0.001]，improve sleep quality[MD=21.66，95%CI（8.07，35.25），P<0.001]，reduced noise level[MD=29.27， 95%CI（10.74，47.79），P<0.001]. White noise could prolong patients’ sleep duration，and reduce patients’ anxiety[MD=-8.11，95%CI（-10.55，-5.68），P<0.001] and depression[MD=-5.86，95%CI（-8.76，-2.96），P<0.001]. Conclusion White noise can significantly improve the sleep status of ICU patients and reduce negative emotions such as anxiety and depression，but the quality of the included studies is low，and the heterogeneity between studies is high，which needs to be further confirmed by large-sample，well-designed and high-quality randomized controlled trials.

Key words: White Noise, Intensive Care Units, Sleep Quality, Meta-Analysis, Evidence-Based Nursing