Music shows benefit as a nonpharmacological intervention for improving sleep in insomnia

In an updated review of randomized controlled trials, music was found to be a potentially effective approach to improving subjective sleep quality for adults with insomnia symptoms.1 The review made it clearer that listening to music could also be a non-pharmacological interventional treatment to improve adults with insomnia, as it is currently used as a sleep aid.

Compared to no intervention or treatment as usual (TAU), results showed moderate confidence in improved sleep quality in people in music groups, as measured by the Pittsburgh Sleep Quality Index (PSQI)2 (average difference [MD], −2.79; 95% CI -3.86 to -1.72; studies, n=10; participants, n = 708). In contrast, the review showed very low confidence evidence for a difference in the effects between groups on the severity of insomnia (MD, -6.96, 95% CI -15.21 to 1.28; studies, n = 2; participants , n = 63).

Lead researcher Kira Jespersen, PhD, MSc, and colleagues noted that “music is likely to enable a large improvement in sleep quality compared to no treatment or treatment as usual. We do not know whether listening to music has an effect on the severity of insomnia (difficulty falling or staying asleep) or the number of times a person wakes up (sleeping) compared to no treatment or treatment as usual.”

Thirteen randomized controlled trials (participants, n = 1007) examining the effect of listening to pre-recorded music for 25 to 60 minutes daily over the course of three days to three months were included in the meta-analysis. Eleven online databases, 2 studies registered up to December 2021 and manually searched reference lists were searched.1 Only 2 of the review’s study authors independently screened the studies for eligibility, selected the records for inclusion, withdrew data, and evaluated the risk of bias of the chosen studies.

Jespersen, assistant professor, Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Aarhus, Denmark, and colleagues wrote: “Listening to music may slightly improve sleep onset latency ( how quickly falls asleep), sleep duration (duration of sleep), and sleep efficiency (how long someone sleeps compared to total time spent in bed), compared to no treatment or treatment as usual None of the studies reported any negative effects caused by listening to music.”

The reviewers rated the certainty of the evidence by the studies using GRADE (Grading of Recommendations, Assessment, Development and Evaluations). In terms of primary outcomes, sleep quality, insomnia severity, sleep onset latency, total sleep time, sleep interruption, sleep efficiency, and side effects were assessed. In addition, the meta-analyses included data on the predefined outcome measures consistently reported by at least 2 homogeneous studies with respect to interventions, outcomes and participants.

Additional findings in 3 studies (participants, n = 197) showed little certainty that listening to music caused problems with sleep latency (MD -0.60, 95% CI -0.83 to -0.37), total sleep time (MD – 0 .69, 95% CI −1.16 to −0.23) and sleep efficiency (MD −0.96, 95% CI −1.38 to −0.54). The studies also showed that music may not have any effect on perceived sleep interruption (MD -0.53, 95% CI -1.47 to 0.40).

Jespersen et al noted: “Our confidence in the sleep quality evidence is only moderate because the people in the studies knew what treatment they were receiving and the people scoring the data sometimes also knew what treatment the participants were receiving, which could introduce biases . We have little confidence in the evidence for the severity of insomnia because the studies were very small and were done in different types of people who knew what treatment they were receiving.”

Further research is needed on the effect of listening to music on other aspects of sleep, along with the consequences of daytime insomnia, the researchers noted. Therefore, more research should focus on measures of daytime functioning as an aspect of sleep, such as mood, fatigue, concentration and quality of life.1

REFERENCES
1. Jespersen KV, Pando-Naude V, Koenig J, Jennum P, Vuust P. Listening to music for adult insomnia. Cochrane Database System Rev. 2022;8(8):CD010459. Published August 24, 2022. doi:10.1002/14651858.CD010459.pub3
2. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A New Tool for Psychiatric Practice and Research. Psychiatry Res. 1989;28(2):193-213. doi:10.1016/0165-1781(89)90047-4
Music shows benefit as a nonpharmacological intervention for improving sleep in insomnia

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