BACKGROUND: The role of noise pollution in chronic obstructive pulmonary disease (COPD) remains unclear. The aim of this study was to investigate the correlation between nighttime sleep noise levels and the risk of acute exacerbations of this lung disease. METHODS: A total of 518 stable COPD patients were enrolled in the study. A portable sound level meter was used to measure the nighttime sleep noise levels. Subsequently, based on a threshold of 40 dB, the patients were divided into a high-noise group (n = 210) and a low-noise group (n = 308). The Pittsburgh Sleep Quality Index was employed to assess the sleep quality of the patients. During the 12-month follow-up, the events of acute exacerbation (i.e., Escalated therapy, Urgent hospitalization, and Admitted to intensive care unit) in these COPD patients were recorded. Multivariate logistic regression was utilized for data analysis. RESULTS: When most potential confounding factors (i.e., demographic variable, chronic disease, risk factor of COPD, status of COPD, and inflammatory indicator) were adjusted, a higher nighttime sleep noise level was found to be associated with acute exacerbations of COPD during the follow-up period. After adjusting the sleep quality score, although the P-value of the above-mentioned correlation was still statistically significant, its level increased significantly, that is, the level of the P-value became closer to the threshold at which it would not be statistically significant. CONCLUSION: There is a significant correlation between relatively high nighttime sleep noise level and acute exacerbations of COPD. Sleep disorders might potentially contribute in some way to the above-mentioned correlation. The exact role of nighttime sleep noise in acute exacerbations of this lung disease and the underlying mechanisms still need further research.