In this early pilot study, we sought to determine if the alteration in these physiologic efects in premature infants in response to ambient noise in the NICU could be assessed evaluating cerebral blood saturation. Tree premature infants, on high fow nasal cannula oxygen support (HFNC), at less than 34 weeks of gestation were included in the study. Tree variables were used to evaluate sound levels due to AAP and EPA guidelines; Leq,1h, L10,1h and Lmax,1min. All of the patients studied were found to be exposed to statistically signifcant noise levels (above recommendation) throughout all of the time periods measured. Noise levels were found to be similarly elevated during the 1 am and 3 pm time periods as well, though not as much as compared to the 7 am measure. A statistically signifcant diference was found within every patient's rSO2 levels in both hemispheres, but also in the absolute diferences of rSO2. Positive signifcant statistical correlations were found between the average rSO2 and Leq,1h (ρ=0.14), Lmax,1min (ρ=0.18), L10,1h (ρ=0.15). Signifcant negative correlations were found between the absolute diference levels and Lmax,1min (ρ=-0.3), and L10,1h (ρ=-0.18) This data highlights the need for further study as to the potential impact of noise on the cerebral physiology of premature infants. Further research is needed to assess the potential long-term side efects of environmental noise on the premature infant’s brain.