The study investigated the effectiveness of a noise and sound environment control program in preventing delirium in children in the intensive care unit. 354 children were included in the research and divided into three groups: a control group received standard care, a second group received noise control, and a third group received noise control combined with white noise masking. The incidence of delirium decreased from 47.5% in the control group to 36.7% in the noise control group and to 31.1% in the combined intervention group. The proportion of days during which children suffered from delirium decreased from 30.7% to 23.6% and then to 23.1%. The incidence of hypoactive delirium (a less visible form) decreased from 18.7% to 6.6%. The program also reduced cortisol levels, indicating a reduced stress response in children. The results show that a comprehensive sound environment management program effectively reduces the incidence of delirium and improves the psychological and physiological stability of critically ill children.