BACKGROUND Sleep exerts modulatory effects on the neuroendocrine system, immune homeostasis, and psychological cognitive functions. As a non-pharmacological intervention, white noise has garnered widespread attention for its potential to improve sleep through mechanisms such as acoustic masking effects and neuromodulation. However, its efficacy varies across different age groups (infants, adults, older adults) and clinical settings (intensive care units vs. non-intensive care units), and a systematic evaluation of these effects remains lacking. OBJECTIVE To evaluate the effect of white-noise therapy on sleep-quality improvement in different age groups (0-3 years: infants and toddlers; 18-64 years: adults; ≥65 years: older adults) and clinical settings (intensive care unit vs. non-intensive care unit). DESIGN Systematic review and meta-analysis. METHODS We will search randomized controlled trials (RCTs) published up to February 15, 2025, in databases including PubMed, Embase, Web of Science, the Cochrane Library, and CNKI. Studies investigating the impact of white noise on sleep quality will be included, with primary outcomes encompassing the Pittsburgh Sleep Quality Index (PSQI), total sleep time (TST), sleep efficiency (SE), number of awakenings (NOA), and wake after sleep onset (WASO). Two investigators will independently screen the literature, extract data, and assess the risk of bias using the Cochrane Risk of Bias tool. Meta-analyses will be performed using RevMan 5.4 and Stata 18.0, with treatment effects expressed as mean difference (MD), standardized mean difference (SMD), and corresponding 95 % confidence intervals (CIs). RESULTS A total of 12 RCTs involving 1301 participants were included in the analysis. The study population comprised 356 infants and young children (aged 0-3 years), 648 adults (aged 18-64 years), and 297 older adults (aged ≥65 years). Among them, 544 were critically ill patients (emergency intensive care unit, coronary care unit, and intensive care unit), and 401 were non-critically ill patients (admitted to general wards or non-hospitalized settings). Meta-analysis revealed that, in the infant and young-child population, white noise significantly prolonged 24-h TST [MD = 137.51 min, 95 % CI (67.80, 207.23), P = 0.0001], whereas it showed no significant effect on nocturnal 12-h TST [MD = 102.56 min, 95 % CI (-39.91, 245.04), P = 0.16]. For SE, white noise did not improve 24-h SE [MD = 7.77 %, 95 % CI (-12.48, 28.39), P = 0.46], but it significantly increased 12-h SE [MD = 6.62 %, 95 % CI (1.72, 11.52), P = 0.008]. In addition, white noise reduced the NOA during both the 24-h period [MD = -19.42, 95 % CI (-35.21, -3.64), P = 0.02] and the 12-h nocturnal period [MD = -1.83, 95 % CI (-3.12, -0.54), P = 0.006]. However, no significant effect was observed on 24-h WASO [MD = -8.65 min, 95 % CI (-27.33, 10.02), P = 0.46]. In the adult and older adult patient populations, white noise significantly reduced PSQI scores, both in adults [MD = -3.70, 95 % CI (-4.90, -2.50), P < 0.001] and in older adults [MD = -2.71, 95 % CI (-4.98, -0.44), P = 0.02]. Across different clinical settings, a significant reduction in PSQI scores was also observed following white noise intervention, both in patients within intensive care units [MD = -4.04, 95 % CI (-6.35, -1.73), P < 0.001] and in non-intensive care unit settings [MD = -2.61, 95 % CI (-3.84, -1.38), P < 0.001]. Sensitivity analysis indicated substantial heterogeneity in PSQI scores among adult patients. However, a leave-one-out analysis demonstrated that the direction of the pooled effect size remained unchanged, consistently supporting the efficacy of the white noise intervention. Furthermore, due to the limited number of included studies for the respective outcomes in infants and young children children, older adults, and ICU/non-ICU patient subgroups, no further sensitivity analyses were performed. CONCLUSION In the infant and toddler population, white n

Auditory stimulation devices (white and pink noise) are used to mask sounds and facilitate relaxation and sleep; however, the effectiveness of this intervention is not well established. This systematic review examined the scientific literature for the effect of specific types of auditory stimulation on sleep outcomes in adults. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guided this review. Searches were conducted in 9 databases for intervention studies that could easily be employed in clinical practice. We excluded other types of auditory stimulation (music alone, binaural tones, and synchronization). Two reviewers screened abstracts and full-text articles for eligibility, with conflicts resolved by a third reviewer, and extracted data. Risk of bias was assessed with the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Thirty-four studies reported results of 1,103 persons participating in 3 categories of interventions: white noise (18), pink noise (11), and 6 multiaudio (some combination of white, pink, music, or silence). Nineteen studies had positive findings in terms of improving sleep outcomes: 6 white noise (33%), 9 pink noise (81.9%), and 4 multiaudio (66.7%). Multiaudio had the lowest (better) risk of bias (mean/standard deviation: 1.67/0.82) compared to white (2.38/0.69) and pink noise (2.36/0.81). Although there was no strong evidence to support use of auditory stimulation, none of the studies reported any adverse effects with short-term application of auditory stimulation during sleep. Future research needs to include confounding factors that can affect outcomes, including one's noise sensitivity, personality, and other conditions or medications that may affect sleep. Capezuti E, Pain K, Alamag E, Chen XQ, Philibert V, Krieger AC. Systematic review: auditory stimulation and sleep. J Clin Sleep Med. 2022;18(6):1697-1709. Systematic review: auditory stimulation and sleep | Journal of Clinical Sleep Medicine | Springer Nature Link Skip to main content Advertisement Systematic review: auditory stimulation and sleep Review Articles Published: 01 June 2022 Volume 18 , pages 1697–1709 ( 2022 ) Cite this article Save article View saved research Journal of Clinical Sleep Medicine Aims and scope Submit manuscript Abstract Study Objectives: Auditory stimulation devices (white and pink noise) are used to mask sounds and facilitate relaxation and sleep; however, the effectiveness of this intervention is not well established. Risk of bias was assessed with the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results: Thirty-four studies reported results of 1,103 persons participating in 3 categories of interventions: white noise (18), pink noise (11), and 6 multiaudio (some combination of white, pink, music, or silence). Nineteen studies had positive findings in terms of improving sleep outcomes: 6 white noise (33%), 9 pink noise (81.9%), and 4 multiaudio (66.7%). Multiaudio had the lowest (better) risk of bias (mean/standard deviation: 1.67/0.82) compared to white (2.38/0.69) and pink noise (2.36/0.81). Auditory Perception Brain Stimulation Circadian Rhythms and Sleep Noise Control Sound Studies Psychoacoustics Music Interventions for Sleep Quality Improvement Abbreviations PSG: polysomnography QAT: Quality Assessment Tool for Quantitative Studies RA: research assistant RCT: randomized controlled trial RoB: risk of bias SD: standard deviation REFERENCES Lustenberger C, Patel YA, Alagapan S, et al. High-density EEG characterization of brain responses to auditory rhythmic stimuli during wakefulness and NREM sleep. Neuroimage. 2018;169:57–68. Google Scholar Lustenberger C, Boyle MR, Alagapan S, Mellin JM, Vaughn BV, Fröhlich F. 2007;9(2); http://www.sleepandhypnosis.org/ing/Pdf/a72d260d52c84ec99e7a751a4c6a1d83.pdf . Accessed January 8, 2022. Gao D, Long S, Yang H, et al. SWS brain-wave music may improve the quality of sleep: an EEG study. Front Neurosci. 2020;14:67. Google Scholar Goel N. Late-night presentation of an auditory stimulus phase delays human circadian rhythms. Am J Physiol Regul Integr Comp Physiol. 2005;289(1):R209– R216. Google Scholar Handscomb L. Use of bedside sound generators by patients with tinnitus-related sleeping difficulty: which sounds are preferred and why? Acta Otolaryngol Suppl. 2006;Dec(556):59–63. Google Scholar Hu RF, Jiang XY, Hegadoren KM, Zhang YH. Television viewing, internet use, and self-reported bedtime and rise time in adults: implications for sleep hygiene recommendations from an exploratory cross-sectional study. Behav Sleep Med. Music therapy improves sleep quality in acute and chronic sleep disorders: a meta-analysis of 10 randomized studies. Int J Nurs Stud. 2014;51(1):51–62. Google Scholar Trahan T, Durrant SJ, Müllensiefen D, Williamson VJ. The music that helps people sleep and the reasons they believe it works: a mixed methods analysis of online survey reports. PLoS One. 2018;13(11):e0206531. Google Scholar Dickson GT, Schubert E. How does music aid sleep? literature review. Sleep Med. 2019;63:142–150. Google Scholar Riedy SM, Smith MG, Rocha S, Basner M. Noise as a sleep aid: a systematic review. Sleep Med Rev. 2021;55:101385. Google Scholar Attarha M, Bigelow J, Merzenich MM. https://doi.org/10.5664/jcsm.9860 Download citation Received : 03 June 2021 Revised : 22 December 2021 Accepted : 23 December 2021 Published : 01 June 2022 Version of record : 01 June 2022 Issue date : 01 June 2022 DOI : https://doi.org/10.5664/jcsm.9860 Share this article Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy shareable link to clipboard Provided by the Springer Nature SharedIt content-sharing initiative Keywords systematic review sleep sleep quality white noise pink noise music insomnia Profiles Ana C.

White noise is purported to mask disruptive noises in the bedroom environment and be a non-pharmacological approach for promoting sleep and improving sleep quality. We conducted a systematic review of all studies examining the relationships between continuous white noise or similar broadband noise and sleep (PROSPERO 2020: CRD42020148736). Animal studies and studies using intermittent white noise to disrupt sleep or enhance slow wave activity were excluded. Two reviewers independently screened titles and abstracts of articles from three databases and assessed risk of bias for the 38 included articles. The primary outcomes described sleep onset latency, sleep fragmentation, sleep quality, and sleep and wake duration. There was heterogeneity in noise characteristics, sleep measurement methodology, adherence to the intervention, control group conditions or interventions, and presence of simultaneous experimental interventions. There was perhaps resultantly variability in research findings, with the extremes being that continuous noise improves or disrupts sleep. Following the GRADE criteria, the quality of evidence for continuous noise improving sleep was very low, which contradicts its widespread use. Additional research with objective sleep measures and detailed descriptions of noise exposure is needed before promoting continuous noise as a sleep aid, especially since it may also negatively affect sleep and hearing.

Sleep is essential for human health, yet millions suffer from insufficient or poor-quality rest. Traditional solutions such as polysomnography are accurate but impractical for continuous home use, while commercial devices often provide limited insights[1]. This paper introduces SleepEase, a mobile application and sensor-equipped hardware system that monitors sleep and delivers adaptive soundscapes to support faster sleep onset. Three core components—mobile app, hardware device, and Firebase backend—work together to provide monitoring, real-time feedback, and long-term data storage [2]. Challenges such as sleep detection accuracy, hardware design, and sound personalization were addressed through careful integration of multiple sensors and adaptive audio options. Experiments demonstrated that white noise and ocean sound reduced sleep latency, while enhanced detection algorithms achieved higher precision and recall compared to baseline methods. Compared with prior methodologies, SleepEase improves accuracy and personalization by combining monitoring with intervention. Ultimately, it presents a practical, scalable solution for at-home sleep improvement.