THE UTILIZATION OF NOISE MASKING INTERVENTIONS ON PATIENT-REPORTED SLEEP QUALITY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

ANGIE C. KING THE UTILIZATION OF NOISE MASKING INTERVENTIONS ON PATIENT-REPORTED SLEEP QUALITY: A SYSTEMATIC REVIEW AND META-ANALYSIS Under the direction of JUSTUS RANDOLPH, Ph.D. Hospital noise can disrupt patients' sleep cycles at night, which is linked to negative physiological outcomes. Considering the potential adverse effects of pharmacological treatment, such as cardiovascular and respiratory depression, it is crucial to assess the effect of nonpharmacological interventions on sleep quality. The use of noise masking devices as a nonpharmacological intervention has been shown to statistically improve the sleep quality of patients; however, the magnitude of the treatment effect remains unclear. The objective of this study was to examine the magnitude of the treatment effect of utilizing noise masking interventions and the effects of different types of interventions, white or pink noise, on sleep quality among hospitalized patients using meta-analysis. The selection criteria included randomized controlled trials (RCTs) and quasi-experimental study designs evaluating the utilization of noise masking interventions in hospitalized patients that measured the effects on sleep quality. Following Cochrane’s guidelines, risk of bias was assessed using the Risk of Bias 2 tool and the ROBINS-I tool. Data synthesis was performed using the SPSS package random-effects model, and the DerSimonian and Laird random-effects model with the Knapp Hartung adjustment was used. Among 3,583 titles, the full text of 140 articles was carefully reviewed. Five studies met the inclusion criteria, and all studies were judged as having a high risk of bias. Noise masking interventions were effective in improving sleep quality among hospitalized patients with (g = 1.60, 95% CI [0.47, 2.75, p = .02]) and without an outlier (g = 1.23, 95% CI [0.44, 2.03, p = .01]). When the types of noise were examined, white noise was more effective in improving sleep quality among hospitalized patients with, g = 2.17, and without an outlier, g = 1.50, than pink noise, g = 1.07. The findings from this study support the use of noise masking to improve sleep quality among hospitalized patients. However, it is important to note the quality of evidence was low according to the GRADE approach. Although there is a concern about the quality of evidence, the large effect sizes were robust and favored using noise making to improve sleep quality.