Effects of music intervention on sleep quality of older adults: A systematic review and meta-analysis

Cognitive Interventions for the Treatment of Insomnia or Poor-Quality Sleep in Community-Dwelling Older People: A Systematic Review and Meta-Analysis

Background: Aging and its pathologies, particularly sleep problems, are increasingly affecting industrialized societies. This study aims to determine the effectiveness of different cognitive interventions for the treatment of insomnia or poor sleep quality in community-dwelling older people. Methodology: A systematic review was carried out from November 2023-July 2024 according to the standards of the Preferred Reporting Items for Systematic Review and Meta-Analyses in the databases. The following databases were consulted: Pubmed, Web of Science, and ClinicalTrials.gov. The studies included patients with sleep problems or insomnia over 60 years of age. To evaluate the quality of the studies, the Critical Appraisal Skills Program Spanish (CASPe) guide was used. Results: Nine clinical trials with intervention groups and control groups belonging to the last 10 years were selected. They were analyzed, and the results were verified via questionnaires, scales, sleep diaries, and objective measures. In general, the implementation of the interventions improved the quality of sleep and symptoms of insomnia. Conclusions: Cognitive interventions have been found to be safe and useful for the treatment of insomnia and poor sleep quality in older people. Furthermore, they are feasible in terms of cost effectiveness and can be easily implemented by primary care teams.

Harmonious ageing: a narrative review of music therapy in the biomedical literature

PURPOSE

As the global population of older adults rises, the United Nations Decade of Healthy Ageing (2021-2030) advocates for disease prevention, management, and enhancing overall wellbeing in older adults. We reviewed the MEDLINE literature under the MeSH term "music therapy" (MT), for its role in promoting healthy ageing.

METHODS

A systematic search of the MEDLINE biomedical database (Ovid) was conducted using "MT" and "Ageing" as keywords, retrieving relevant full-text studies in English. Preference was given to more recent studies with higher levels of evidence. The studies were categorised according to the biopsychosocial framework into physical, cognitive and social domains, and further subcategorised based on their relevance to disease prevention and management.

RESULTS

The initial search identified 1147 articles, of which 75 met inclusion criteria. Studies encompassed both MT and music interventions delivered by non-music therapists. Overall, studies showed benefits in the promotion of physical health, including enhancing exercise capacity and improving fitness among older adults. Results were promising in managing conditions such as Parkinson's disease and frailty. In the area of brain health, studies showed cognitive benefits, particularly in attention and processing speed among older adults. Socially, there was evidence of enhanced quality of life, reduced anxiety and depression, and improved social engagement, including in people living with dementia, underscoring the role of music in fostering emotional connections and mitigating caregiver stress.

CONCLUSION

MT and interventions can enhance biopsychosocial health outcomes in older adults. Research should prioritise isolating MT's specific effects, standardising definitions and methodologies, and exploring therapeutic mechanisms.

The art of sleep: examining sleep strategies in the general population with a focus on the use of music for sleep

Insomnia is highly prevalent and associated with serious health issues. Despite the negative impact of poor sleep on mind and body, most people do not seek treatment. This study aimed to examine the strategies used to improve sleep in the general population with a particular focus on music. A survey was distributed via Facebook advertisements to Danish adults aged ≥18 years. Among 3667 responders, a representative subsample of 1195 participants was randomly selected based on age and sex. Data analysis involved chi-square tests and logistic regression with adjustments for age, sex, education, and insomnia status. The results showed that nearly all participants utilised strategies to aid their sleep, with the most common strategies being 'following a routine' (73%), 'reducing caffeine in the afternoon/evening' (65%) and 'lowering the temperature in the bedroom' (62%). Individuals with insomnia utilised significantly more strategies (average 8.4 strategies) compared to those without insomnia (average 6.6 strategies). Among all participants, 20% reported using music for sleep at least 1-2 times/month, whereas 11% used music for sleep weekly, and 4.5% used music almost daily. Music users tended to be younger, and they were also more likely to have insomnia. By evaluating 24 different sleep strategies, this study shows that people do several things to promote sleep in their daily lives. These findings enhance our understanding of sleep behaviour, providing an important fundament for targeting future public health interventions to reduce the use of sleep disruptive strategies and promote strategies known to improve sleep health.

Effect of Tai Chi combined with music therapy on the cognitive function in older adult individuals with mild cognitive impairment

Background

With the global aging population increasing, cognitive impairment among the older adult, particularly Mild Cognitive Impairment (MCI), has garnered remarkable attention. MCI, often a precursor to dementia, presents an opportunity for early intervention. This study investigates the effects of Tai Chi combined with music therapy on the cognitive function in older adult individuals with MCI.

Methods

In this randomized controlled trial, 66 older adult participants with MCI were randomly assigned to one of the following three groups: a Control Group (CG), a Tai Chi Group (TCG), and a Tai Chi Combined with Music Group (TCMG), with 22 participants in each group. Cognitive function was evaluated over a 12-week intervention using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and Stroop Color and Word Test.

Results

Baseline characteristics showed no significant differences among the groups. The TCG and TCMG exhibited significant improvements after 16-week intervention. The participants with TCG group improved in MoCA score (P = 0.005), attention accuracy (P = 0.031), and delayed recall (P = 0.003). The participants with TCMG showed notable enhancements in MoCA (P = 0.000), MMSE (P = 0.001), attention accuracy (P = 0.025), visuospatial and executive functions (P = 0.001), naming (P = 0.014), abstraction (P = 0.020), and delayed recall (P = 0.006). The CG experienced decreased language repetition ability (P = 0.042) and delayed recall (P = 0.030).

Conclusion

Twelve weeks of Tai Chi combined with music therapy substantially improved cognitive function in older adult individuals with MCI. This combined intervention is more effective than Tai Chi alone, highlighting its potential as a non-pharmacological approach to enhance cognitive health in the aging population.

Music and Sleep Hygiene Interventions for Pregnancy-Related Insomnia: An Online Randomized Controlled Trial

INTRODUCTION

Approximately 50% to 60% of all pregnant women suffer from insomnia during pregnancy. Pregnancy-related insomnia has been associated with severe outcomes for both mother and child postnatally. Currently, the treatment of pregnancy-related insomnia is often neglected due to a lack of suitable treatments. This online assessor-masked randomized controlled trial aimed to evaluate the effectiveness of music listening and sleep hygiene for treating pregnancy-related insomnia.

METHODS

We recruited first-time pregnant women at the end of the second trimester with a report of poor sleep. Participants in the music and sleep hygiene (MSH) group received standard sleep hygiene advice and were instructed to listen to music daily at bedtime for 4 weeks. They could choose from 6 sleep playlists of different genres. Participants randomized to the sleep hygiene alone (SH) group received standard sleep hygiene only. Primary outcomes were sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI) and insomnia severity measured with the Insomnia Severity Index.

CLINICALTRIALS

gov Identifier: NCT04633395.

RESULTS

Among the 98 participants receiving the online intervention, 31 participants in the MSH group (62%) and 40 participants in the SH group (80%) completed the postintervention measurements. Both groups experienced improved sleep quality during the intervention period (PSQI change, -2.10; 95% CI, -3.27 to -0.93; P < .001), with no significant difference between the groups. Similarly, insomnia symptoms were reduced (Insomnia Severity Index change, -3.42; 95% CI, -5.02 to -1.83; P < .001) with no significant difference in the effect between groups. There was a significant difference in adherence to sleep hygiene between the MSH and SH groups (42% vs 8%; P = .007).

DISCUSSION

Sleep quality and insomnia severity can be improved in pregnant women with relatively simple interventions like music listening and sleep hygiene advice. These results align with previous research, but larger trials are recommended to support introduction into clinical practice.

A systematic review and meta-analysis of music interventions to improve sleep in adults with mental health problems

BACKGROUND

Music listening has been used as a sleep intervention among different populations. This systematic review and meta-analysis aimed to explore whether music is an effective sleep aid in adults with mental health problems.

METHODS

We searched for studies investigating music interventions for sleep in adults with mental health problems. The primary outcome was subjective sleep quality; secondary outcomes were objective sleep outcomes, quality of life, and other mental health symptoms. Risk of bias assessment (RoB1) and random-effect model were used for the systematic review and meta-analyses.

RESULTS

The initial screening (n = 1492) resulted in 15 studies in the systematic review. Further qualified studies led to the meta-analysis of sleep quality (n = 7), depression (n = 5), and anxiety (n = 5). We found that the music listening intervention showed a potential effect on subjective sleep quality improvement compared to treatment-as-usual or no-intervention groups. When excluding an outlier study with an extreme effect, the meta-analysis showed a moderate effect on sleep quality (Hedges' g = -0.66, 95% CI [-1.19, -0.13], t = -3.21, p = 0.0236). The highest risk of bias was the blinding of participants and researchers due to the nature of the music intervention.

CONCLUSIONS

Our results suggest that music interventions could have the potential to improve sleep quality among individuals with mental health problems, even though more high-quality studies are needed to establish the effect fully.

The role of arts therapies in mitigating Sleep Initiation and Maintenance Disorders: a systematic review

INTRODUCTION

Arts therapies offer effective non-pharmacological intervention for Sleep Initiation and Maintenance Disorders (SIMDs), encompassing both passive and active modalities. This review assesses their effectiveness and ethical considerations, focusing on music therapy, meditation, and Tai Chi.

METHODS

Following PRISMA guidelines, a detailed search across PubMed, the Cochrane Library, Web of Science, and CNKI identified 17 relevant RCTs. Utilizing the Joanna Briggs Institute (JBI) quality criteria and the PICO(S) framework for data extraction ensured methodological integrity.

RESULTS

Analysis shows arts therapies significantly improve sleep quality. Music therapy and meditation yield immediate benefits, while Tai Chi and Qigong require longer commitment for significant outcomes.

DISCUSSION

The link between SIMDs and mental health issues like anxiety, stress, and depression suggests arts therapies not only enhance sleep quality but also address underlying mental health conditions. The evidence supports a wider adoption of arts therapies in treating SIMDs due to their dual benefits.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, ID: CRD42024506393.

Effectiveness of binaural beat music combined with rhythmical photic stimulation on older people with depressive symptoms in long-term care institution: a quasi-experimental pilot study

BACKGROUND

Many older adults residing in long-term care often face issues like poor sleep, reduced vitality, and depression. Non-pharmacological approaches, specifically Binaural Beat Music (BBM) and Rhythmic Photic Stimulation (RPS), may alleviate these symptoms, yet their efficacy in this demographic has not been extensively explored.

AIMS

This study investigated the effects of combined BBM and RPS interventions on sleep quality, vitality, and depression among older residents with depressive symptoms in long-term care facilities.

METHODS

Using a quasi-experimental design, a total of 88 older adults with depressive symptoms from Taiwanese daytime care centers were divided into the BBM with RPS, and Sham groups (44 each). They underwent 20-minute daily sessions of their assigned treatment for two weeks. The BBM with RPS group listened to 10 Hz binaural beat music with 10 Hz photic stimulation glasses, and the Sham group received non-stimulating music and glasses.

RESULTS

After the intervention, participants in the BBM with RPS groups showed significant improvements in vitality and depressive mood, with a notable increase in sympathetic nervous system activity. Conversely, the Sham group exhibited significant deterioration in vitality and mental health, with a significant increase in parasympathetic activity. Additionally, compared with the Sham group, the BBM and RPS groups showed significant improvements in vitality, mental health, and depression, with a significant increase in sympathetic nervous activity.

CONCLUSION

The two-week intervention suggests that the combination of BBM and RPS, as a non-invasive intervention, can potentially improve vitality, mental health, and depressive mood among older adults in long-term care institutions.

Music Intervention for older adults: Evidence Map of Systematic Reviews

BACKGROUND

With the increasing aging population, the health problems of the elderly have received increasing attention. As a non-pharmacological interventions, music intervention has been widely used in clinical practice to improve the physical and mental health of the elderly. This article aims to provide a comprehensive review of existing systematic reviews on the health effects of music interventions for older adults in clinical practice.

METHODS

The study utilized the evidence map methodology, which involved identifying all relevant systematic reviews, meta-analysis from 7 electronic databases from their inception to November 2022. The studies were analyzed using AMSTAR 2.

RESULTS

The researchers identified 67 studies, with the majority published in the past 5 years. The effects of music interventions were categorized into 4 groups of health outcomes: positive (58 results), potentially positive (4 results), inconclusive (2 results), and no effect (3 results). The health outcomes were further classified into 5 groups: psychological well-being, cognitive functioning, physiological responses, quality of life, and overall well-being.

CONCLUSIONS

The study revealed that music interventions for older adults can have positive or potentially positive effects on health outcomes, encompassing psychological well-being, cognitive functioning, physiological responses, quality of life, and overall well-being. However, some studies yielded inconclusive or no effect. The study offers valuable insights for healthcare professionals and serves as a visual resource to access evidence-based information on the use of music interventions in promoting health and addressing various conditions in older adults.

A bibliometric analysis of sleep in older adults

Background

Sleep problems severely affect the quality of life in the elderly and have gradually gained attention among scholars. As a major hot spot of current research, sleep in older adults is highly exploratory and of great significance for human health.

Objective

Therefore, in this study, the current state of the art of sleep research in older adults was analyzed through the visual mapping function of CiteSpace software. Using this software, we analyzed popular research questions and directions and revealed the development trends and research frontiers of this field.

Methods

In this paper, we searched the Web of Science database for sleep-related studies focusing on older adults and analyzed the number of publications, journals, authors, institutions, country regions, and keywords by using CiteSpace software.

Results

Our results revealed that the number of publications concerning sleep in older adults has gradually increased; after 2017, this field underwent rapid development. The journal Sleep has published the majority of the articles on sleep in older adults and has the highest citation frequency. The Journal of the American Geriatrics Society has the highest impact factor and CiteScore among the top 10 journals in terms of the number of published articles. The United States has the highest number of publications and most of the leading institutions in this field are located in the United States, with the University of California, Los Angeles, and the University of Pittsburgh having the highest number of publications. Dzierzewski JM is the most published author and has played an important role in guiding the development of this field. Research in this area is focused on insomnia, sleep quality, depression, and sleep duration.

Conclusion

The rapid development of sleep research in older adults, which shows a yearly growth trend, indicates that this field is receiving increasing attention from researchers. Insomnia in older adults is the most concerning problem in this field. At the same time, future research should continue to focus on the impact of sleep disorders on older adults to improve sleep and quality of life in older adults.