Keywords
Premature
Noise
Intensive care units
Neonatal
Sleep
Neonatal nursing
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To analyze strategies for noise control and sleep promotion in preterm newborns in neonatal units. Methods: This is an integrative literature review conducted in six methodological stages. The search was carried out in the following databases: Latin American and Caribbean Health Sciences Literature (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Scientific Electronic Library Online (SciELO), Nursing Database (BDENF), and Scopus, using the controlled descriptors “Noise,” “Sleep,” “Premature Infant,” and “Neonatal Intensive Care Unit,” combined with the Boolean operators AND and OR. Studies published between 2019 and 2025, in Portuguese, English, and Spanish, and available in full text were included. Results: The main sources of noise identified were alarms, medical equipment, and staff communication. The most effective strategies included alarm management, environmental control, light reduction, care organization, use of sound-attenuating incubators, and multidisciplinary team training. Combined interventions were associated with reduced environmental stress and significant improvement in sleep quality among preterm newborns. Final considerations: It can be concluded that integrated strategies are essential to promote a safe neonatal environment, improving sleep, neurological development, and clinical stability in preterm infants.
References
ALTIMIER L, PHILLIPS R. The neonatal integrative developmental care model: advanced clinical applications. Newborn and Infant Nursing Reviews, 2020; 16(4): 230-244.
ARNON S, et al. Music therapy intervention in an open bay neonatal intensive care unit room is associated with less noise and higher signal to noise ratios: a case-control study. Children, 2022; 9(8): 1187.
BLOCH-SALISBURY E, et al. Assessment of a hearing protection device on infant sleep in the neonatal intensive care unit. Journal of Sleep Research, 2023; 32(2): e13610.
CASEY L, et al. A two-pronged approach to reduce noise levels in the neonatal intensive care unit. Early Human Development, 2020; 146: 105073.
CROFTS K, et al. Noise levels in a tertiary neonatal intensive care unit: an observational study. Journal of Neonatal Nursing, 2025; 31(3): 101642.
DEVRAMANI M, et al. A quality improvement initiative to reduce the noise levels in a tertiary care neonatal intensive care unit. Journal of Neonatology, 2025; 39(3): 257-264.
DÜKEN ME, YAYAN EH. The effects of massage therapy and white noise application on premature infants’ sleep. Explore (NY), 2024; 20(3): 319-327.
FAEZ N, et al. Practices for respecting the newborn’s sleep-wake cycle: interventional study in the neonatal intensive care unit. Journal of Neurosciences in Rural Practice, 2024; 15(2): 278-285.
FUCILE S, et al. Noise reduction in the neonatal intensive care unit: an exploratory study. Journal of Neonatal Nursing, 2023; 29(2): 330-333.
GHOLAMI N, et al. Effect of a noise reduction program on stress of premature neonates in neonatal intensive care unit. Journal of Neonatal Nursing, 2023; 29(1): 194-198.
HERNÁNDEZ-SALAZAR AD, et al. Level and noise sources in the neonatal intensive care unit of a reference hospital. Investigación y Educación en Enfermería, 2020; 38(3): e13.
KÖSE S, et al. Establishing a contextualized intervention program for noise reduction in a neonatal intensive care unit. HERD: Health Environments Research & Design Journal, 2024; 17(4): 65-74.
MARTINS VE, et al. Níveis de ruído em Unidade Terapia Intensiva Neonatal antes e após intervenção educativa. Revista Enfermagem UERJ, 2022; 30: e67466.
MONSON BB, et al. Neonatal intensive care unit incubators reduce language and noise levels more than the womb. Journal of Perinatology, 2020; 40(4): 600-606.
PAGE MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021; 372: n71.
PINEDA R, et al. NICU sensory experiences associated with positive outcomes: an integrative review of evidence from 2015-2020. Journal of Perinatology, 2023; 43(7): 837-848.
PUYANA-ROMERO V, et al. Influence of the NICU on the acoustic isolation of a neonatal incubator. Frontiers in Pediatrics, 2020; 8: 588.
RANGASWAMY DR, et al. Quieting the neonatal intensive care unit: a quality improvement initiative. World Journal of Clinical Pediatrics, 2024; 13(3): 96018.
SIBRECHT G, et al. Noise or sound management in the neonatal intensive care unit for preterm or very low birth weight infants. Cochrane Database of Systematic Reviews, 2024; (5): CD010333.
SOUZA MT, et al. Revisão integrativa: o que é e como fazer. Einstein, 2010; 8(1): 102-106.
VAN GILST D, et al. Effects of the neonatal intensive care environment on circadian health and development of preterm infants. Frontiers in Physiology, 2023; 14: 1243162.
WHITTEMORE R, KNAFL K. The integrative review: updated methodology. Journal of Advanced Nursing, 2005; 52(5): 546-553.