Effects of Night-Shift Noise Exposure and Medical Equipment Alarms on Daytime Sleep Quality among Intensive Care Unit Nurses: The Mediating Role of Alarm Fatigue

Purpose: This study examined the relationships between night-shift noise exposure, alarm fatigue, and daytime sleep quality in intensive care unit (ICU) nurses, and the mediating effects of alarm fatigue on the associations of noise exposure and medical equipment alarm frequency with daytime sleep quality. Methods: This descriptive correlational study included 125 ICU nurses from a hospital in Busan, South Korea. Data were collected from April 21 to May 12, 2025. A GM-1356 meter measured noise levels in dBA. Validated Korean versions of the A Technology Hazard Survey and the Verran and Snyder-Halpern Sleep Scale assessed alarm fatigue and daytime sleep quality, respectively. Data were evaluated using correlation, hierarchical regression, and mediation analyses with SPSS version 27.0. Results: The mean night-shift noise level was 54.24±2.95 dBA. Alarm fatigue was negatively correlated with daytime sleep quality (r=-.51, <i>p</i><.001) and was the strongest predictor (β=-.47, <i>p</i><.001). Night-shift noise exposure and alarm frequency were not directly associated with sleep quality. Alarm frequency was positively correlated with alarm fatigue (r=.22, <i>p</i>=.012), which mediated its association with sleep quality (indirect effect β=-.24, 95% CI [-0.45, -0.07]). Nurses caring for three patients had poorer sleep quality than those caring for two (β=-.19, <i>p</i>=.031). Conclusion: ICU nurses were exposed to high night-shift noise levels and frequent alarms and experienced alarm fatigue and poor daytime sleep quality. Therefore, organizational interventions, including optimized alarm management and appropriate nurse staffing, are essential for reducing alarm fatigue and promoting patient safety and the well-being of nurses.