The effectiveness of white noise therapy on sleep quality and physiological stability among premature infants in the neonatal intensive care unit
Keywords:
Premature Infants, Physiological stability, Sleep quality, White noise, NICUAbstract
Premature infants admitted to the neonatal intensive care unit (NICU) are exposed to clinical noise, light, invasive procedures, respiratory support, and repeated handling that may disturb sleep and physiological organization. Sleep protection is a core element of neuroprotective developmental care because it supports brain maturation, energy conservation, autonomic regulation, and recovery. White noise is a simple auditory-based non-pharmacological intervention that may mask sudden environmental sounds and provide a steady stimulus resembling the intrauterine acoustic environment. This case study described the observed effects of white noise therapy on quiet sleep duration and physiological stability among premature infants with respiratory distress syndrome in the NICU at RSD dr. Soebandi Jember. A descriptive case study was conducted with two premature infants diagnosed with respiratory distress syndrome. White noise was administered once daily for 30 minutes at approximately 45-50 dB after routine clinical stabilization. Quiet sleep duration was assessed using the state organization component of the Neonatal Behavioral Assessment Scale, while heart rate, respiratory rate, and oxygen saturation were obtained from bedside monitors before and after intervention. Quiet sleep duration increased from 10 to 30 minutes in Case 1 and from 5 to 20 minutes in Case 2. Heart rate decreased from 120 to 108 beats/minute in Case 1 and from 130 to 121 beats/minute in Case 2. Respiratory rate decreased from 52 to 50 breaths/minute in Case 1 and from 59 to 50 breaths/minute in Case 2, while oxygen saturation remained stable at 100% in both cases. White noise therapy was associated with longer quiet sleep duration and more stable physiological parameters. This intervention may be considered as an adjunctive, low-risk developmental care strategy when delivered within safe sound limits and under continuous clinical monitoring.
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