This study aims to investigate the effects of preoperative white noise and pink noise interventions on sleep quality, anxiety, postoperative pain, nausea, and physiological parameters in patients undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA). A total of 165 adult patients will be randomly allocated into three equal groups: a white noise group, a pink noise group, and a control group (55 participants per group). On the evening prior to surgery (around 10:00 PM), participants in the experimental groups will listen to standardized white noise or pink noise at 45-50 dB for 30 minutes via over-ear, active noise-cancelling headphones. Participants in the control group will receive routine perioperative care without any auditory intervention. Data regarding sleep quality, anxiety levels, pain intensity, nausea, and hemodynamics (blood pressure, heart rate, respiratory rate, and oxygen saturation) will be collected using validated scales and physiological monitoring before and after the intervention as well as in the postoperative period (at 0, 12, and 24 hours).
Scheduled for elective primary unilateral total hip or knee arthroplasty
Aged 18 years or older
American Society of Anesthesiologists (ASA) physical status classification I, II, or III
Literate and able to understand, communicate, and independently complete questionnaires in Turkish
Diagnosed psychiatric, cognitive, or neurological disorders that impair communication or scale completion
Clinically diagnosed chronic sleep disorders (e.g., severe obstructive sleep apnea, chronic insomnia)
Regular use of sedative-hypnotics, anxiolytics, or psychiatric medications within the last month
Administration of preoperative sedative or hypnotic premedication on the night before surgery
Parallel
White Noise Intervention
BehavioralParticipants will listen to standardized white noise played at a volume of 45-50 dB for 30 minutes using over-ear active noise-cancelling headphones on the preoperative night (at approximately 10:00 PM).
Pink Noise Intervention
BehavioralParticipants will listen to standardized pink noise played at a volume of 45-50 dB for 30 minutes using over-ear active noise-cancelling headphones on the preoperative night (at approximately 10:00 PM).
Preoperative Sleep Quality
Assessed using the Richard-Campbell Sleep Questionnaire (RCSQ). The scale evaluates depth of sleep, falling asleep latency, awakenings, time spent awake, and overall sleep quality (scores range from 0 to 100 mm, where higher scores represent better sleep quality).
Preoperative State Anxiety
Assessed using the State-Trait Anxiety Inventory - State Subscale (STAI-S / STAI Form TX-1). The scale consists of 20 items rated on a 4-point Likert scale (1 = Not at all to 4 = Very much so). Total scores range from 20 to 80, with higher scores reflecting greater levels of acute state anxiety.
Systolic and Diastolic Blood Pressure
Systolic and diastolic blood pressure measured in millimeters of mercury (mmHg) using a calibrated clinical monitor to evaluate autonomic nervous system responses to auditory interventions.
Heart Rate
Heart rate measured in beats per minute (bpm) using a clinical monitor to evaluate autonomic nervous system responses to auditory interventions.
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