{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:09:35Z","timestamp":1784887775527,"version":"3.55.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"132","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    The study aimed to investigate the relationship between noise spectrum characteristics across different frequency bands in the intensive care unit (ICU) and the occurrence of delirium and sleep structure disturbances in patients with multiple organ dysfunction syndrome (MODS).\n                    <jats:bold>Methods:<\/jats:bold>\n                    We enrolled 172 patients with MODS admitted to the Zhoushan Hospital ICU from January 2021 to September 2025. We conducted continuous environmental noise monitoring using a spectrum analyzer and measured equivalent continuous A-weighted sound pressure levels (LAeq) for low-, medium-, and high-frequency bands during daytime, nighttime, and over 72 h. We assessed delirium using the Confusion Assessment Method for the ICU (CAM-ICU) within 7 days, and patients were divided into a delirium group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200982) and a non-delirium group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200990). We compared clinical data and polysomnography-derived sleep parameters.\n                    <jats:bold>Results:<\/jats:bold>\n                    The 72-h LAeq was highest in the low-frequency band, and daytime and nighttime LAeq exceeded World Health Organization limits. Delirium incidence was 47.67%. Patients in the delirium group had higher low- and medium-frequency noise levels (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05). Nighttime low-frequency noise showed a positive correlation of sleep latency with awakenings and a negative correlation with slow-wave sleep (SWS) and rapid eye movement (REM) sleep proportions (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05). Multivariate logistic regression identified elevated nighttime low-frequency noise and decreased SWS and REM proportions as independent factors for delirium (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05).\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Nighttime low-frequency noise exposure in the ICU is associated with sleep structure disturbance with increased delirium risk in patients with MODS. Interventions targeting low-frequency noise sources may improve outcomes.\n                  <\/jats:p>","DOI":"10.4103\/nah.nah_59_26","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:00:25Z","timestamp":1783569625000},"page":"656-664","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Association of Intensive Care Unit Noise Spectrum with Delirium and Sleep Structure Disturbance in Patients with Multiple Organ Dysfunction Syndrome"],"prefix":"10.4103","volume":"28","author":[{"given":"Bin","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Intensive Care Unit, Haining People\u2019s Hospital, No. 2 Qianjiang West Road, Haining, 314400, Zhejiang, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Zhoushan Hospital, Zhoushan, 316021, Zhejiang, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YingYing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Haining People\u2019s Hospital, No. 2 Qianjiang West Road, Haining, 314400, Zhejiang, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"R1-20260724","doi-asserted-by":"crossref","first-page":"e70056","DOI":"10.1111\/wvn.70056","article-title":"Impact of environmental noise on inpatient outcomes: A scoping review","volume":"22","author":"Sonoda","year":"2025","journal-title":"Worldviews Evid Based Nurs"},{"key":"R2-20260724","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/cc12870","article-title":"An investigation of sound levels on intensive care units with reference to the WHO guidelines","volume":"17","author":"Darbyshire","year":"2013","journal-title":"Crit Care"},{"key":"R3-20260724","doi-asserted-by":"crossref","first-page":"923","DOI":"10.5005\/jp-journals-10071-24811","article-title":"Voices from the ICU: Perspectives on humanization in critical care settings","volume":"28","author":"Paul","year":"2024","journal-title":"Indian J Crit Care Med"},{"key":"R4-20260724","doi-asserted-by":"crossref","first-page":"e70027","DOI":"10.1111\/wvn.70027","article-title":"Mortality risk following delirium in older inpatients: A systematic review and meta-Analysis","volume":"22","author":"P\u00e9rez-Ros","year":"2025","journal-title":"Worldviews Evid Based Nurs"},{"key":"R5-20260724","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1017\/cjn.2020.62","article-title":"Effect of sleep disorder on delirium in post-cardiac surgery patients","volume":"47","author":"Wang","year":"2020","journal-title":"Can J Neurol Sci"},{"key":"R6-20260724","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1089\/sur.2017.298","article-title":"Multiple organ dysfunction: The defining syndrome of sepsis","volume":"19","author":"Ziesmann","year":"2018","journal-title":"Surg Infect (Larchmt)"},{"key":"R7-20260724","first-page":"713","article-title":"Reliability and validity of the Confusion Assessment Method for the Intensive Care Unit in patients with dementia [in Chinese]","volume":"39","author":"Gan","year":"2017","journal-title":"Zhejiang Medical Journal"},{"key":"R8-20260724","doi-asserted-by":"crossref","first-page":"257","DOI":"10.2478\/jccm-2021-0023","article-title":"Evaluation of sleep architecture using 24-h polysomnography in patients recovering from critical illness in an intensive care unit and high dependency unit: A longitudinal, prospective, and observational study","volume":"7","author":"Prajapat","year":"2021","journal-title":"J Crit Care Med (Targu Mures)"},{"key":"R9-20260724","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1097\/CCM.0b013e31828a3f75","article-title":"A typical sleep in ventilated patients: empirical electroencephalography findings and the path toward revised ICU sleep scoring criteria","volume":"41","author":"Watson","year":"2013","journal-title":"Crit Care Med"},{"key":"R10-20260724","first-page":"604","article-title":"Sleep disturbances in the critically ill patients: Role of delirium and sedative agents","volume":"77","author":"Trompeo","year":"2011","journal-title":"Minerva Anestesiol"},{"key":"R11-20260724","first-page":"CD010333","article-title":"Noise or sound management in the neonatal intensive care unit for preterm or very low birth weight infants","volume":"5","author":"Sibrecht","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"R12-20260724","first-page":"220","article-title":"Mitigating intensive care unit noise: Design-led modeling solutions","volume":"17","author":"Jonescu","year":"2024","journal-title":"calculated acoustic outcomes, and cost implications. HERD"},{"key":"R13-20260724","doi-asserted-by":"crossref","first-page":"10858","DOI":"10.1038\/s41598-025-94365-8","article-title":"Noise and sound in the intensive care unit: A cohort study","volume":"15","author":"Tahvili","year":"2025","journal-title":"Sci Rep"},{"key":"R14-20260724","doi-asserted-by":"crossref","first-page":"170552","DOI":"10.1016\/j.scitotenv.2024.170552","article-title":"Low-frequency noise impairs righting reflex behavior by disrupting central nervous system in the sea slug Onchidium reevesii","volume":"918","author":"Tu","year":"2024","journal-title":"Sci Total Environ"},{"key":"R15-20260724","doi-asserted-by":"crossref","first-page":"7121295","DOI":"10.1155\/2023\/7121295","article-title":"Sleep deprivation and heart rate variability in healthy volunteers: Effects of REM and SWS sleep deprivation","volume":"2023","author":"Xu","year":"2023","journal-title":"Comput Math Methods Med"},{"key":"R16-20260724","doi-asserted-by":"crossref","first-page":"130","DOI":"10.4103\/nah.nah_79_21","article-title":"Noise pollution in intensive care unit: A hidden enemy affecting the physical and mental health of patients and caregivers","volume":"24","author":"Pal","year":"2022","journal-title":"Noise Health"},{"key":"R17-20260724","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.sleep.2023.04.029","article-title":"The effect of TENS on sleep: A pilot study","volume":"107","author":"Zhou","year":"2023","journal-title":"Sleep Med"},{"key":"R18-20260724","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.aucc.2022.04.006","article-title":"Effects of nonpharmacological interventions on sleep improvement and delirium prevention in critically ill patients: A systematic review and meta-analysis","volume":"36","author":"Kang","year":"2023","journal-title":"Aust Crit Care"},{"key":"R19-20260724","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1097\/AUD.0000000000001625","article-title":"Sleep-associated traits and hearing difficulties in noise: A bidirectional mendelian randomization study","volume":"46","author":"Liu","year":"2025","journal-title":"Ear Hear"},{"key":"R20-20260724","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1161\/CIRCRESAHA.123.323584","article-title":"Transportation noise pollution and cardiovascular health","volume":"134","author":"M\u00fcnzel","year":"2024","journal-title":"Circ Res"},{"key":"R21-20260724","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1002\/jhm.13218","article-title":"Sleep and circadian disruptors: Unhealthy noise and light levels for hospitalized pediatric patients","volume":"18","author":"Fidler","year":"2023","journal-title":"J Hosp Med"},{"key":"R23-20260724","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1177\/08850666211055649","article-title":"Patterns of delirium in a pediatric intensive care unit and associations with noise pollution","volume":"37","author":"Weatherhead","year":"2022","journal-title":"J Intensive Care Med"}],"container-title":["Noise and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/nah.nah_59_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:00:15Z","timestamp":1784887215000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/nah.nah_59_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":22,"journal-issue":{"issue":"132","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/nah.nah_59_26","relation":{},"ISSN":["1463-1741"],"issn-type":[{"value":"1463-1741","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2026-03-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}