Effects of Noise Reduction Management on Anxiety, Sleep Quality, and Early Postoperative Stress Responses in Patients After Thoracoscopic Lung Surgery

Objective: To investigate the effects of systematic noise reduction management on postoperative anxiety, sleep quality, and early stress responses in patients undergoing elective thoracoscopic lung surgery. Methods: This retrospective cohort study enrolled 150 patients who underwent elective thoracoscopic lung surgery at the First Affiliated Hospital of Soochow University in 2025. Patients were divided into a control group ( n  = 75) receiving routine nursing care and an observation group ( n  = 75) additionally receiving systematic noise reduction management. Anxiety (Self-Rating Anxiety Scale, SAS), sleep quality (Richards–Campbell Sleep Questionnaire, RCSQ), heart rate variability (HRV) indices (standard deviation of normal-to-normal intervals [SDNN], root mean square of successive differences [RMSSD], and low-frequency/high-frequency ratio [LF/HF]), and stress markers (serum cortisol [Cor], C-reactive protein [CRP], and procalcitonin [PCT]) were compared between groups at 1 day before surgery and at 1 and 6 days after surgery. Results: Daytime, nighttime, and 24-hour noise levels were significantly lower in the observation group than in the control group (all P < 0.01). At 1 day after surgery, SAS scores increased and RCSQ scores decreased in both groups, with no significant intergroup differences ( P > 0.05). At 6 days after surgery, the observation group had significantly lower SAS scores (52.67 ± 5.21 versus 55.33 ± 6.85, P  = 0.008) and higher RCSQ scores (48.45 ± 6.54 versus 40.87 ± 5.92, P < 0.001). Serum Cor, CRP, and PCT increased in both groups at day 1 and decreased by day 6, when they were significantly lower in the observation group (Cor 380.80 ± 42.79 versus 402.45 ± 32.43 nmol/L, P < 0.001; CRP 39.56 ± 6.33 versus 48.34 ± 7.89 mg/L, P < 0.001; PCT 0.12 ± 0.06 versus 0.15 ± 0.08 ng/mL, P  = 0.017). HRV indices decreased at day 1 and recovered by day 6, when SDNN, RMSSD, and LF/HF were significantly higher in the observation group (all P < 0.01). Conclusion: Systematic noise reduction management was associated with lower anxiety levels, improved sleep quality, and attenuated early postoperative stress responses after thoracoscopic lung surgery, supporting its value as an adjunct to routine nursing care.