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Sleep · product guide

Earplugs: does it work?

Cheap and effective at cutting noise if you insert them properly. The evidence comes mostly from noisy hospital wards; the trade-off is missing alarms.

Limited evidenceReviewed September 2026

What it is

Foam plugs block the most sound when rolled thin and inserted deep. Silicone putty covers the ear opening and suits small or sensitive ear canals. Flanged and filtered 'high-fidelity' plugs block less sound but more evenly, which some people find less claustrophobic. Custom-moulded plugs fit best but cost more. Sleep earbuds that play masking sound are a separate, pricier option.

The rating on the box (NRR in the US, SNR in Europe) is a lab figure. Real-world protection is usually much lower, mostly because plugs aren't inserted deeply enough.

How strong is the evidence?

Limited evidence

A Cochrane review of intensive-care trials found low-quality evidence that earplugs and/or eye masks improve sleep and may lower delirium risk, and a systematic review of 19 studies found mostly subjective improvements. In healthy volunteers exposed to recorded ICU noise and light, earplugs plus masks restored REM sleep and melatonin. There are few trials at home, where noise is usually lower.

The claims you'll see, checked

Earplugs improve sleep in noisy settings

Holds up

Consistent but low-quality evidence, mostly from hospitals and lab noise simulations.

The highest noise rating is best for sleep

False

A higher rating helps only if the plug fits and stays in. For sleep, a comfortable plug you'll wear all night beats a high number.

Noise-cancelling sleep earbuds block snoring better than foam

Unproven

Active cancellation works best on steady low tones; irregular snoring is harder. Few independent tests.

What to look for

  • A fit for your ear canal. A variety pack is the cheapest way to find it.
  • A low profile if you sleep on your side.
  • Foam for maximum blocking, silicone putty for small or sensitive canals, reusable silicone to cut waste.
  • Filtered plugs if you want to still hear some sound, for example in a shared room.

What to skip

  • Chasing the highest rating if the plug is uncomfortable or falls out.
  • App-connected earbuds when a plug does the job, unless you want masking sound or an alarm only you can hear.

How to use it

  • Foam: roll into a thin, crease-free cylinder, pull the top of your ear up and back, insert, and hold for 20-30 seconds while it expands.
  • If they work loose, try a smaller size or another shape rather than pushing deeper.

Who should be careful

  • You may not hear smoke alarms, a baby or someone at the door. Consider a vibrating or bed-shaker alarm if you rely on hearing one.
  • Nightly use can push wax deeper or irritate the ear canal. See a clinician if you get ear pain, discharge or hearing changes.
  • Insert plugs with clean hands, replace disposable foam plugs often, and wash reusable ones to reduce infection risk.
  • Don't use them with a perforated eardrum or an active ear infection without medical advice.

The studies

Every citation is checked against its PubMed record.

  1. Non-pharmacological interventions for sleep promotion in the intensive care unit
    Hu RF, Jiang XY, Chen J, Zeng Z, Chen XY, Li Y, et al. · Cochrane Database of Systematic Reviews · 2015 · Systematic review

    30 trials (1,569 ICU adults). Low-quality evidence that earplugs and/or eye masks increased total sleep time and lowered delirium risk (risk ratio 0.55); most studies using objective sleep measures found no benefit.

  2. Effect of the use of earplugs and eye mask on the quality of sleep in intensive care patients: a systematic review
    Locihová H, Axmann K, Padyšáková H, Fejfar J · Journal of Sleep Research · 2018 · Systematic review

    19 studies (1,379 people). Most found better subjective sleep quality with earplugs and eye masks, and possibly less delirium; objective measures were not clearly improved and study methods varied widely.

  3. Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment
    Hu RF, Jiang XY, Zeng YM, Chen XY, Zhang YH · Critical Care · 2010 · Crossover study

    14 healthy volunteers slept with recorded ICU noise and light. The noise and light reduced REM sleep; wearing earplugs and eye masks gave more REM sleep, fewer arousals and higher melatonin.