Noise in the Hospital on the Road to Recovery

There were many experiences while spending 57 days in hospital beds in 2025. I plan to write a book about the experiences and more about the road to recovery. I will share some of the experiences in this weekly blog post. The topic this week is Noise.

In the earliest history of Earth, natural soundscapes were limited mainly to wind, water, volcanic activity and, later, animal calls, so what people now call “noise” in the sense of intrusive, man‑made sound did not yet exist. As human settlements grew into cities, mechanical technologies such as carts, metalworking and later factory machinery began to layer new, harsher sounds onto this background, prompting some of the first noise regulations in places like ancient Rome, where Julius Caesar restricted wheeled traffic at night because of the clatter on stone streets. With the Industrial Revolution and then the spread of automobiles, railways, amplified music and aircraft, urban sound levels rose sharply, and by the twentieth century doctors and policymakers increasingly recognized excessive city noise as a health and environmental problem, leading to organized anti‑noise campaigns and modern noise‑control. Doctors may agree about noise in the outside environment, but what about noise in hospitals.

I can confirm by experience hospitals are persistently noisy, the noise is significant, and it is well-documented having a negative impact on patients. Noise sources in the hospital include obnoxious beeping from Intravenous (IV) pumps, alarm beeps indicating a patient fell out of bed or had a wearable sensor setting off a trigger, staff conversations, patients and visitors laughing, crying or screaming, food or medicine carts with plastic wheels on tiled floors (where is Julius when we need him), medical equipment, intercoms, pagers, and hospital loudspeakers making all types of announcements 24 hours per day. Hospital noise frequently far exceeds the World Health Organization (WHO) recommendations of 35 decibels (dB) during the day and 30 at night. Actual noise in a hospital often ranges from 55 to 70 dB and can even peak above 80 dB. This level of noise is similar to a busy city street or a kitchen blender making a frozen margarita.

A Nursing News blog article, “Dangerous Decibels: Hospital Noise More Than a Nuisance” lists how hospital noise affects patients[i].

• Sleep Disruption: Frequent noise interruptions fragment sleep, preventing the deep rest needed for immune function, tissue repair, and recovery. Poor sleep can slow healing, increase pain sensitivity, worsen mood, and prolong hospital stays.
• Stress and Anxiety: Excess noise triggers physiological stress, raising blood pressure, heart rate, and stress hormone levels (e.g., cortisol). This often results in heightened pain, anxiety, and feelings of helplessness.
• Weakened Immune Response: Sleep loss and stress from noise can suppress immune function, making patients more vulnerable to infections and potentially leading to longer recovery periods.
• Delirium and Confusion: Especially for elderly or critically ill patients, excessive noise is linked to confusion, delirium, and worsened mental health.

A hospital security company, Alertify, in “The Impact of Noise on Patient Recovery & Sleep in Hospitals”, the company said the overall patient dissatisfaction from high noise levels, as measured by hospital surveys, can impact hospital ratings and funding. Staff are also affected, with increased fatigue, headaches, distraction, and a higher risk of communication errors. This can worsen patient care and safety outcomes.[ii]

Hospital noise is a well-recognized, measurable risk to patient recovery and well-being. I personally endured the impact described in the nursing blog. So, if noise is a recognized problem by patients and hospital staff, why isn’t something being done about it?

Having served on the board of a regional hospital for ten years, there were constant major issues with regard to budgets and staff levels. Now, more than ten years later, I know those problems are greater. Over ten years on the board and various committees, I never once heard of noise as an issue. Being in a hospital bed for 57 days, I witnessed factors affecting the issue. I had sleep deprivation every single day.

At 5:30 AM, I was asleep when I heard a light knock at the door. A Patient Care Technician (PCT) came in, turned on the lights, and took my vitals, blood pressure, temperature, and oxygen saturation. Then he or she would typically say, “I’ll close the door so you can get some sleep”. Five minutes later, there was another light knock. This time it was a phlebotomist. He or she came in, turned on the lights, and took a blood sample every day. After leaving the room, turning off the lights, and after five minutes, another light knock at the door. It was one of several doctors making their rounds, then it was the assigned nurse, then it was food service bringing my breakfast, and then a hospitalist, and then a “transporter” to wheel me to another floor for an echocardiogram or an x-ray or an MRI. Then food service again to ask for lunch and dinner choice. One person knocked on the door when I was sleeping. I said, “come in”. It was a lady carrying a small harp. She asked if she could play some relaxing music to help me rest. Then a hospital patient satisfaction person knocked lightly to come in and ask how things were going. Etc., all day, every day. In most all cases, the person would say, “Ok if I close your door so you get some sleep?” Hardly. During one of my stays, I was across the hall from the elevators. They were quite noisy. Staff and food tray carts added to the noise.

A reorganization of the schedules could reduce the knocks at the door, but it would be havoc for the individual departments and the work schedules of staff. There are some other proven noise reduction interventions described in the “British Journal of Healthcare Management”.[iii] A few of them are described below.   

• Designated Quiet Times: Implementing specific periods during the day and night when activity and noise are minimized dramatically lowers decibel levels and improves patient and staff satisfaction. In one study, average noise was reduced from 64.6 dB to 24 dB during these quiet times, and patient satisfaction rose from 2% to 96%.[iv]
• Audio-Visual Noise Alerts: Installing noise meters and visual alert systems (“noise traffic lights”) notify staff when noise exceeds safe levels, prompting immediate corrective actions.[v]
• Environmental Adjustments: Using acoustic panels, curtains, and sound-absorbing materials in walls, ceilings, and floors helps reduce sound transmission and reverberation. Reorienting beds and relocating noisy equipment can also contribute.[vi]
• Music Therapy: Controlled use of soothing music helps alleviate anxiety, improve moods, and reduce the negative impact of noise. Studies show combining noise reduction with music therapy improves emotional wellbeing and cognitive function.[vii] In my case the offer of music was one more interruption.
• Reducing Clinical Interruptions: Organizing workflows to minimize overnight interruptions and non-essential patient checks further enhances sleep opportunity.[viii]
• Equipment Upgrades: Substituting noisy equipment, installing acoustic enclosures, and using double-glazed windows and soundproofing for doors and windows are highly effective for reducing baseline noise.[ix]
• Architectural Design: Planning for noise control during hospital construction or renovation, like zoning, buffer rooms, and strategic room placement, have a lasting impact on ward noise.[x]

Patients exposed to quieter wards reported measurably better sleep, less anxiety, lower pain scores, and higher overall satisfaction. Post-intervention studies saw increases in sleep opportunity and decreased clinical interruptions, as well as improved emotional wellbeing, which all contribute to faster recovery rates and better outcomes.[xi] The literature suggests if a hospital effectively combines environmental, behavioral, and technological noise-reduction interventions, it can lead to meaningful improvements in patient recovery and sleep quality. I suspect most hospital executives would find these interventions would be overly complicated and costly. I can say after 57 days in a hospital, I never got used to the noise.

Two hospitals took strong action to reduce noise, with measurable benefits for patients:

• Holy Spirit Hospital in Pennsylvania found hard ceilings made patient rooms sound like echo chambers, and noise levels were a frequent complaint among patients, especially at night. To address this, the hospital invested in a sound masking system along with upgraded, high-performance ceiling tiles designed to absorb and block sound. Patient satisfaction ratings jumped to 98%. Staff also benefited, with better ability to communicate privately and without disturbing patients.[xii]
• Elizabeth Hospital in Wisconsin renovated its emergency department after patients and staff both raised concerns about high noise levels and a lack of privacy. They installed ceiling tiles with high noise reduction coefficients, switched to quieter flooring, extended walls for better sound insulation, and improved the seals on doors. Patient privacy improved, and noise complaints dropped significantly. Patient survey scores in the category “would you recommend this hospital?” jumped from the 55th to the 90th percentile after the changes.[xiii]

Both cases demonstrate that targeted environmental and acoustical investments can dramatically reduce hospital noise and produce measurable improvements in patient experience and recovery outcomes. Other interventions also have potential benefits. The area of noise reduction is a perfect target for philanthropic support.

[i] Diane Sparacino, “Dangerous Decibels: Hospital Noise More Than a Nuisance,”  rn.com (2025), https://www.rn.com/blog/nursing-news/dangerous-decibels-hospital-noise/

[ii] MS Zina Jawadi and MD Alexander Chern, “Hospitals Are Noisy. They Don’t Have to Be,”  AANC.org (2023), https://www.aamc.org/news/hospitals-are-noisy-they-don-t-have-be

[iii] Poonam Gupta et al., “Implementation of Noise-Reduction Strategies and Designated Quiet Time in an Intensive Care Unit,”  British Journal of Healthcare Management (2022), https://www.magonlinelibrary.com/doi/full/10.12968/bjhc.2022.0036

[iv] Ibid.

[v] Ibid.

[vi] Ibid.

[vii] Ibid.

[viii] Ibid.

[ix] Ibid.

[x] Ibid.

[xi] Jessica Nye, “Rest-Promoting Interventions in Hospital Ward Improve Inpatient Sleep,”  Rheumatology Advisor(2025), https://www.rheumatologyadvisor.com/news/rest-promoting-interventions-hospital-improve-sleep/

[xii] “Case Study: Acoustics and Patient Satisfaction in Hospitals,”  Lencore (2020), https://www.lencore.com/case-studies/case-study-acoustics-and-patient-satisfaction-in-hospitals/

[xiii] HCD Guest Author, “Pebble Partner St. Elizabeth Hospital Emergency Room Renovation,”  healthcare design(2020), https://healthcaredesignmagazine.com/news/pebble-partner-st-elizabeth-hospital-emergency-room-renovation/1660/