Music Therapy Found to Significantly Improve Sleep Quality in Older Adults

April 21, 2021
Matthew Gavidia
Matthew Gavidia

Matthew is an associate editor of The American Journal of Managed Care® (AJMC®). He has been working on AJMC® since 2019 after receiving his Bachelor's degree at Rutgers University–New Brunswick in journalism and economics.

Music therapy among older adults was associated with significant improvements in sleep quality, with sedative music cited as more effective than rhythm-centered music.

Sleep quality in older adults may be significantly improved through music therapy, particularly through slow-tempo, soft-volume, and smooth melodic music, according to study findings published today in Journal of the American Geriatrics Society.

Affecting 40% to 70% of older adults, the researchers say that sleep issues increase with age due to changes in sleep architecture and circadian regulation. Moreover, the impact of impaired sleep could prove significant, with prior studies associating sleep issues with poor quality of life and an increased risk of dementia and death.

Recently, a systematic review and meta-analysis of randomized controlled trials confirmed that listening to music is a potentially successful nonpharmacological intervention for improving sleep quality in adults.

As the researchers explain, there are 2 classifications of music: (1) sedative, which is characterized by a slow tempo of 60 to 80 beats per minute, soft volume, and smooth melody, and (2) rhythmic, which is characterized by fast tempos, loud volume, and rhythmic patterns.

“Based on psychophysiological theory, listening to sedative music can improve sleep by modulating sympathetic nervous system activity and the release of neuroendocrine levels of cortisol, thereby lowering levels of anxiety and stress responses,” added the study authors.

With the impact of music on improving sleep quality among community-dwelling older adults—at least 60 years old and living independently—remaining unclear, the researchers conducted their own systematic review and meta-analysis to examine the association.

They selected 5 randomized controlled trials that met inclusion criteria, totaling 142 participants in the music therapy groups and 146 participants in the control groups. Each participant was a community-dwelling adult whose listening duration ranged from 30 minutes to 1 hour over a period ranging from 2 days to 3 months.

Participants were observed for the primary assessment of sleep quality, measured via the Pittsburgh Sleep Quality Index (PSQI), with subgroup analyses also conducted to explore whether the effectiveness of music intervention differed by treatment durations, as measured in weeks, as well as whether effectiveness varied by music type (sedative or rhythmic).

In their findings, significantly better sleep quality was reported in participants of the music therapy groups compared with those who did not listen to music (mean difference (MD), −1.96; 95% CI, −2.23 to −1.73; P = .003), with sleep quality further improved among people listening to music for longer than 4 weeks (MD, −2.61; 95% CI, −4.72 to −0.50; P = .02).

Furthermore, older adults who listened to sedative music exhibited a more effective improvement in sleep quality than those who listened to rhythm-centered music (MD, −2.35; 95% CI, –3.59 to −1.10; P = .0002).

“Music intervention is an effective strategy and is easy to administer by a caregiver or health care worker,” noted the researchers. “Music therapy might be the first line of therapy to recommend in older adults with sleep disturbances, which would reduce the need for or dependence on sedatives and sleeping medication.”

Reference

Chen CT, Fang CJ, Chang YJ, et al. Effect of music therapy on improving sleep quality in older adults: A systematic review and meta-analysis. J Am Geriatr Soc. Published online April 21, 2021. doi:10.1111/jgs.17149