Impact of Hospital Environmental Noise on Sleep Quality and Rehabilitation Outcomes in Patients with Acute Leukaemia Receiving Chemotherapy.

Abstract

Background: For patients with acute leukaemia receiving chemotherapy, hospital noise may affect sleep and hinder recovery. Understanding these effects and exploring mitigation strategies are crucial for enhancing patient rehabilitation.

Objective: This work aimed to evaluate the effects of hospital environmental noise on sleep quality and rehabilitation outcomes amongst patients with acute leukaemia undergoing chemotherapy, providing evidence for improvement in the ward environment.

Methods: A retrospective cohort study included 102 patients with acute leukaemia treated between January 2023 and March 2025. On the basis of the noise level of the environment, patients were divided into a high-noise group ( n  = 52) and a low-noise group ( n  = 50), receiving equivalent treatment. Primary outcomes were the Pittsburgh Sleep Quality Index (PSQI), Leeds Sleep Evaluation Questionnaire (LSEQ) and bone marrow puncture results. Secondary indicators included perceived noise sources, Difficulties in Emotion Regulation Scale (DERS), Insomnia Severity Index (ISI) and haematologic parameters. Statistical analysis was conducted using SPSS (version 25.0). Independent sample t -test or Wilcoxon rank sum test was used for continuous variables, and chi-square test or analysis of covariance (ANCOVA) was used for categorical variables. P < 0.05 was considered statistically significant.

Results: The 24-hour average noise levels of the high- and low-noise groups were 59.9 and 50.5 dBA, respectively. The high-noise group showed significantly higher PSQI, DERS and ISI scores and lower LSEQ scores ( P < 0.05). Four weeks after treatment, the high-noise group had higher blast + promyelocyte proportions, longer time to reach <5%, slower white blood cell/neutrophil/platelet count recovery and less C-reactive protein reduction ( P < 0.05). The main noise sources were caregivers/visitors and snoring.

Conclusion: Hospital environmental noise significantly impairs sleep quality and delays bone marrow recovery in patients with acute leukaemia receiving chemotherapy, negatively affecting physiological rehabilitation and treatment efficacy.