{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:10:40Z","timestamp":1788887440858,"version":"build-2803163510"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"133","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":[[2026,7]]},"abstract":"\n Objective:<\/jats:bold>\n To examine the associations of ward noise exposure with sleep efficiency, anxiety status, and length of stay in patients with chronic obstructive pulmonary disease (COPD) complicated by pneumonia.\n Methods:<\/jats:bold>\n This retrospective, single-center observational study included 90 hospitalized patients with COPD complicated by pneumonia. Clinical data were extracted from medical records, and ward noise and sleep data were obtained from routinely collected ward environmental and nursing monitoring records. Patients were categorized into high- and low-noise exposure groups according to 24-hour equivalent sound pressure level (Leq) using a 50-dB cutoff. Daytime and nighttime periods were defined as 06:00\u201322:00 and 22:00\u201306:00, respectively. State-Trait Anxiety Inventory scores at admission and discharge were compared between groups, and within-group changes were assessed using paired t-tests. Multivariable linear regression was performed to evaluate the associations among noise exposure, sleep efficiency, anxiety, and length of stay.\n Results:<\/jats:bold>\n The high-noise exposure group had lower sleep efficiency and higher discharge state anxiety scores than the low-noise exposure group (both\n P<\/jats:italic>\n < 0.05). State anxiety scores decreased from admission to discharge in both groups (high-noise group,\n P\u2009<\/jats:italic>\n =\u20090.001; low-noise group,\n P<\/jats:italic>\n < 0.001), whereas trait anxiety scores did not change significantly within either group (both\n P<\/jats:italic>\n > 0.05). The high-noise exposure group also had a longer length of stay (\n P<\/jats:italic>\n < 0.05). The 24-hour Leq was significantly correlated with nighttime Leq. Multivariable analysis showed that high-noise exposure was independently associated with decreased sleep efficiency, increased discharge state anxiety, and prolonged length of stay after adjustment for demographic factors, smoking history, disease severity, cardiovascular comorbidity, and baseline state anxiety where appropriate. Formal mediation analysis was not performed; therefore, the potential associations between noise exposure and sleep disruption, anxiety, and length of stay should be interpreted as exploratory.\n Conclusion:<\/jats:bold>\n Ward noise exposure was associated with sleep efficiency, short-term anxiety status, and length of stay in patients with COPD complicated by pneumonia. Optimizing the inpatient acoustic environment may help improve sleep and psychological comfort, but prospective interventional studies are needed to determine whether noise reduction can shorten length of stay.\n <\/jats:p>","DOI":"10.4103\/nah.nah_96_26","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:03:24Z","timestamp":1788343404000},"page":"1036-1041","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Ward Noise Exposure with Sleep Efficiency, Anxiety, and Length of Stay in Patients with COPD Complicated by Pneumonia"],"prefix":"10.4103","volume":"28","author":[{"given":"YueFang","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YinFang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HongXia","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"R1-20260908","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1186\/s12889-024-17686-9","article-title":"Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis","volume":"24","author":"Al Wachami","year":"2024","journal-title":"BMC Public Health"},{"key":"R4-20260908","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/S0140-6736(13)61613-X","article-title":"Auditory and non-auditory effects of noise on health","volume":"383","author":"Basner","year":"2014","journal-title":"Lancet"},{"key":"R5-20260908","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":"R6-20260908","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1056\/NEJM199701233360402","article-title":"A prediction rule to identify low-risk patients with community-acquired pneumonia","volume":"336","author":"Fine","year":"1997","journal-title":"N Engl J Med"},{"key":"R7-20260908","first-page":"132","article-title":"Expert consensus on the acute exacerbation of chronic obstructive pulmonary disease in China (revision in 2023). (Chinese)","volume":"43","year":"2023","journal-title":"Int J Resp"},{"key":"R8-20260908","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.5665\/sleep.3142","article-title":"Measuring sleep: accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography","volume":"36","author":"Marino","year":"2013","journal-title":"Sleep"},{"key":"R10-20260908","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/BF00960624","article-title":"Reliability and factorial structure of the Chinese version of the State-Trait Anxiety Inventory","volume":"10","author":"Shek","year":"1988","journal-title":"J Psychopathol Behav Assess"},{"key":"R11-20260908","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1055\/s-0040-1702196","article-title":"Pneumonic versus nonpneumonic exacerbations of chronic obstructive pulmonary disease","volume":"41","author":"Crisafulli","year":"2020","journal-title":"Semin Respir Crit Care Med"},{"key":"R12-20260908","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.bja.2017.09.006","article-title":"Systematic review of the effects of intensive-care-unit noise on sleep of healthy subjects and the critically ill","volume":"120","author":"Horsten","year":"2018","journal-title":"Br J Anaesth"},{"key":"R13-20260908","first-page":"1204","article-title":"Too loud to handle? Transportation noise and cardiovascular disease","volume":"39","author":"M\u00fcnzel","year":"2023","journal-title":"Can J Cardiol"},{"key":"R14-20260908","doi-asserted-by":"crossref","first-page":"100059","DOI":"10.1016\/j.sleepx.2022.100059","article-title":"Sleep in hospitalized pediatric and adult patients: a systematic review and meta-analysis","volume":"4","author":"Burger","year":"2022","journal-title":"Sleep Med X"},{"key":"R15-20260908","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.5665\/sleep.2810","article-title":"A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression","volume":"36","author":"Alvaro","year":"2013","journal-title":"Sleep"},{"key":"R16-20260908","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/S2215-0366(20)30136-X","article-title":"Sleep disturbance and psychiatric disorders","volume":"7","author":"Freeman","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"R17-20260908","first-page":"209","article-title":"How to improve inpatient sleep in regular care wards: a systematic review and meta-analysis of sleep disturbers and non-pharmacological interventions","volume":"22","author":"Burger","year":"2023","journal-title":"Acute Med"},{"key":"R18-20260908","first-page":"e0885","article-title":"The effectiveness of interventions to reduce sound levels in the ICU: a systematic review","volume":"5","author":"Vreman","year":"2023","journal-title":"Crit Care Explor"},{"key":"R19-20260908","doi-asserted-by":"crossref","first-page":"100047","DOI":"10.1016\/j.sleepx.2022.100047","article-title":"Patient-nurse agreement on inpatient sleep and sleep disturbing factors","volume":"4","author":"van den Ende","year":"2022","journal-title":"Sleep Med X"}],"container-title":["Noise and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/nah.nah_96_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:04:36Z","timestamp":1788887076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/nah.nah_96_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":16,"journal-issue":{"issue":"133","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/nah.nah_96_26","relation":{},"ISSN":["1463-1741","1998-4030"],"issn-type":[{"value":"1463-1741","type":"print"},{"value":"1998-4030","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-04-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}