The hospital sound environment is complex. Alarms, medical equipment, activities, and ventilation generate noise that may present occupational problems as well as hinder recovery among patients. In this study, sound measurements and occupant evaluations were conducted in a neurological intensive care unit. Staff completed questionnaires regarding psychological and physiological reactions to the sound environment. A-weighted equivalent, minimum, and maximum (L-Aeq,L-AFMin,L-AFMax) and C-weighted peak (L-CPeak) sound pressure levels were measured over five days at patient and staff locations. Acoustical descriptors that may be explored further were investigated, including level distributions, restorative periods, and spectral content. Measurements near the patients showed average L-Aeq values of 53-58 dB. The mean length of restorative periods (L-Aeq below 50 dB for more than 5 min) was 9 and 13 min for day and night, respectively. Ninety percent of the time, the LAFMax levels exceeded 50 dB and L-CPeak exceeded 70 dB. Dosimeters worn by the staff revealed higher noise levels. Personnel perceived the noise as contributing to stress symptoms. Compared to the majority of previous studies, this study provides a more thorough description of intensive care noise and aids in understanding how the sound environment may be disruptive to occupants. (c) 2008 Acoustical Society of America.