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A Summary of a Cochrane Review: Music for insomnia in adults
G Model EUJIM 537 No. of Pages 2
European Journal of Integrative Medicine xxx (2015) xxx–xxx
Contents lists available at ScienceDirect
European Journal of Integrative Medicine journal homepage: www.elsevier.com/eujim
Review article
A Summary of a Cochrane Review: Music for insomnia in adults L. Susan Wielanda , Nancy Santessob,* a b
University of Maryland, Baltimore MD, USA McMaster University, Hamilton, Canada
Contents 1. 2. 3. 4.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . Music and insomnia . . . . . . . . . . . . . . . . . . What does the research say? . . . . . . . . . . Where does this information come from? Acknowledgments . . . . . . . . . . . . . . . . . . .
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1. Introduction Review authors in the Cochrane Collaboration conducted a review of the effects of music for insomnia in adults. After searching for all relevant studies, they found 6 studies. This summary presents the review findings of the effects of music versus no music on sleep-related outcomes. 2. Music and insomnia Insomnia is a common sleep problem that may include difficulty falling asleep, staying asleep, or other problems. It can cause difficulties with daytime functioning and may negatively affect quality of life. Many people use music to help them fall asleep or to improve their sleep quality. Studies have been conducted to test whether music could improve sleep onset latency (or time to fall asleep), sleep efficiency (or percentage of time in bed spent asleep) and other sleep outcomes as reported by the participants or by using polysomnography (a type of sleep test that measures physiological changes associated with sleep, such as brain waves and eye movements). 3. What does the research say? There were six studies with 314 people who had poor sleep quality. Five of the studies with a total of 264 people tested the effects of music on sleep quality measured on the Pittsburgh Sleep Quality Index (PSQI). This scale asks people to report on their duration of sleep, sleep efficiency, sleep quality, sleep onset latency, sleep medication, sleep disturbances, and daytime
* Corresponding author. E-mail address: [email protected] (N. Santesso).
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dysfunction. The PSQI results in a total score between 0 (good sleep) and 21 (severe sleep problems). One study with a total of 50 people used polysomnography and self-report to measure the effects of music on sleep onset latency, total sleep time, sleep interruption, and sleep efficiency. People in the studies were randomly selected to listen to prerecorded music either alone or with relaxation instructions, or to not listen to music. The studies each lasted between 3 and 35 days. Four studies instructed people to listen to the music at bedtime, but two studies did not specify the time of day. Three studies provided a single recording, and three studies allowed the people to select from a range of options or to freely select their own music. The music styles ranged from classical Western or classical Chinese to popular, new age, eclectic, and jazz. The evidence from the studies was of moderate to very low quality. None of the studies blinded participants to their treatment assignment, and the knowledge about treatment assignment could have affected how the participants assessed their sleep. Some outcomes were measured by only one study, so there is very little information on those outcomes. In summary, the research found that when people with poor sleep quality listen to music at bedtime, sleep quality probably improves. The effect of music upon sleep onset latency, total sleep time, sleep interruption, or sleep efficiency is uncertain. There is no information about adverse effects. See Table 1 for more details of the above. There are currently two studies being conducted on the topic, and we may have more and better evidence in the future. 4. Where does this information come from? This summary is based on a Cochrane systematic review: Jespersen KV, Koenig J, Jennum P, Vuust P. Music for insomnia in
http://dx.doi.org/10.1016/j.eujim.2016.04.007 1876-3820/ ã 2016 Published by Elsevier GmbH.
Please cite this article in press as: L.S. Wieland, N. Santesso, A Summary of a Cochrane Review: Music for insomnia in adults, Eur. J. Integr. Med. (2016), http://dx.doi.org/10.1016/j.eujim.2016.04.007
G Model EUJIM 537 No. of Pages 2
2
L.S. Wieland, N. Santesso / European Journal of Integrative Medicine xxx (2015) xxx–xxx
Table 1 Summary of findings table: Effects of music measured at 3–35 days. What was measured
Without music
Sleep quality (5 studies, 264 people) Measured on the Pittsburgh Sleep Quality Index (range 0–21). Lower scores mean better quality sleep. Time to fall asleep, sleep time, interrupted sleep, sleep efficiency (1 study, 50 people) Adverse events
Scores ranged from On average 2.80 units lower O 5.9 to 12.67 units (from 3.42 to 2.14 lower) moderatea
With music*
Quality of the evidence
What happens with music
There is probably an improvement in sleep quality.
There were small differences between people who listened to music and people who did not.
O O O very lowb
The effect of music on these outcomes is uncertain.
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No trials reported adverse events or that sleep became worse after listening to music.
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Details about the quality of the evidence: a Evidence was moderate quality because the studies did not blind participants to their treatment status. b Evidence was very low quality because the studies did not blind participants to their treatment status and the effect is very imprecise (very few people were in the study and differences were not calculated). * The numbers in the brackets show the range in which the actual effect could be using a 95% confidence interval.
adults. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD010459. DOI: 10.1002/14651858.CD010459.pub2. The Cochrane Collaboration is an independent global network of people who publish Cochrane systematic reviews. Many of the people are volunteers who write reviews by pulling together scientific studies to answer health care questions. These reviews may answer questions about whether, for example, certain vitamins work in diabetes. The Cochrane Complementary Medicine Field promotes Cochrane systematic reviews which cover complementary and alternative medicine in many conditions and diseases. For more information, please visit http://cam.cochrane. org.
Acknowledgments This article was prepared on behalf of the Cochrane Complementary Medicine Field with funding from the US National Center for Complementary and Integrative Health (NCCIH) of the US National Institutes of Health (grant number R24 AT001293). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This Summary of Findings column series in the European Journal of Integrative Medicine is coordinated and edited by L. Susan Wieland, the Coordinator of the Cochrane Complementary Medicine Field.
Please cite this article in press as: L.S. Wieland, N. Santesso, A Summary of a Cochrane Review: Music for insomnia in adults, Eur. J. Integr. Med. (2016), http://dx.doi.org/10.1016/j.eujim.2016.04.007
European Journal of Integrative Medicine xxx (2015) xxx–xxx
Contents lists available at ScienceDirect
European Journal of Integrative Medicine journal homepage: www.elsevier.com/eujim
Review article
A Summary of a Cochrane Review: Music for insomnia in adults L. Susan Wielanda , Nancy Santessob,* a b
University of Maryland, Baltimore MD, USA McMaster University, Hamilton, Canada
Contents 1. 2. 3. 4.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . Music and insomnia . . . . . . . . . . . . . . . . . . What does the research say? . . . . . . . . . . Where does this information come from? Acknowledgments . . . . . . . . . . . . . . . . . . .
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1. Introduction Review authors in the Cochrane Collaboration conducted a review of the effects of music for insomnia in adults. After searching for all relevant studies, they found 6 studies. This summary presents the review findings of the effects of music versus no music on sleep-related outcomes. 2. Music and insomnia Insomnia is a common sleep problem that may include difficulty falling asleep, staying asleep, or other problems. It can cause difficulties with daytime functioning and may negatively affect quality of life. Many people use music to help them fall asleep or to improve their sleep quality. Studies have been conducted to test whether music could improve sleep onset latency (or time to fall asleep), sleep efficiency (or percentage of time in bed spent asleep) and other sleep outcomes as reported by the participants or by using polysomnography (a type of sleep test that measures physiological changes associated with sleep, such as brain waves and eye movements). 3. What does the research say? There were six studies with 314 people who had poor sleep quality. Five of the studies with a total of 264 people tested the effects of music on sleep quality measured on the Pittsburgh Sleep Quality Index (PSQI). This scale asks people to report on their duration of sleep, sleep efficiency, sleep quality, sleep onset latency, sleep medication, sleep disturbances, and daytime
* Corresponding author. E-mail address: [email protected] (N. Santesso).
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dysfunction. The PSQI results in a total score between 0 (good sleep) and 21 (severe sleep problems). One study with a total of 50 people used polysomnography and self-report to measure the effects of music on sleep onset latency, total sleep time, sleep interruption, and sleep efficiency. People in the studies were randomly selected to listen to prerecorded music either alone or with relaxation instructions, or to not listen to music. The studies each lasted between 3 and 35 days. Four studies instructed people to listen to the music at bedtime, but two studies did not specify the time of day. Three studies provided a single recording, and three studies allowed the people to select from a range of options or to freely select their own music. The music styles ranged from classical Western or classical Chinese to popular, new age, eclectic, and jazz. The evidence from the studies was of moderate to very low quality. None of the studies blinded participants to their treatment assignment, and the knowledge about treatment assignment could have affected how the participants assessed their sleep. Some outcomes were measured by only one study, so there is very little information on those outcomes. In summary, the research found that when people with poor sleep quality listen to music at bedtime, sleep quality probably improves. The effect of music upon sleep onset latency, total sleep time, sleep interruption, or sleep efficiency is uncertain. There is no information about adverse effects. See Table 1 for more details of the above. There are currently two studies being conducted on the topic, and we may have more and better evidence in the future. 4. Where does this information come from? This summary is based on a Cochrane systematic review: Jespersen KV, Koenig J, Jennum P, Vuust P. Music for insomnia in
http://dx.doi.org/10.1016/j.eujim.2016.04.007 1876-3820/ ã 2016 Published by Elsevier GmbH.
Please cite this article in press as: L.S. Wieland, N. Santesso, A Summary of a Cochrane Review: Music for insomnia in adults, Eur. J. Integr. Med. (2016), http://dx.doi.org/10.1016/j.eujim.2016.04.007
G Model EUJIM 537 No. of Pages 2
2
L.S. Wieland, N. Santesso / European Journal of Integrative Medicine xxx (2015) xxx–xxx
Table 1 Summary of findings table: Effects of music measured at 3–35 days. What was measured
Without music
Sleep quality (5 studies, 264 people) Measured on the Pittsburgh Sleep Quality Index (range 0–21). Lower scores mean better quality sleep. Time to fall asleep, sleep time, interrupted sleep, sleep efficiency (1 study, 50 people) Adverse events
Scores ranged from On average 2.80 units lower O 5.9 to 12.67 units (from 3.42 to 2.14 lower) moderatea
With music*
Quality of the evidence
What happens with music
There is probably an improvement in sleep quality.
There were small differences between people who listened to music and people who did not.
O O O very lowb
The effect of music on these outcomes is uncertain.
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No trials reported adverse events or that sleep became worse after listening to music.
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Details about the quality of the evidence: a Evidence was moderate quality because the studies did not blind participants to their treatment status. b Evidence was very low quality because the studies did not blind participants to their treatment status and the effect is very imprecise (very few people were in the study and differences were not calculated). * The numbers in the brackets show the range in which the actual effect could be using a 95% confidence interval.
adults. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD010459. DOI: 10.1002/14651858.CD010459.pub2. The Cochrane Collaboration is an independent global network of people who publish Cochrane systematic reviews. Many of the people are volunteers who write reviews by pulling together scientific studies to answer health care questions. These reviews may answer questions about whether, for example, certain vitamins work in diabetes. The Cochrane Complementary Medicine Field promotes Cochrane systematic reviews which cover complementary and alternative medicine in many conditions and diseases. For more information, please visit http://cam.cochrane. org.
Acknowledgments This article was prepared on behalf of the Cochrane Complementary Medicine Field with funding from the US National Center for Complementary and Integrative Health (NCCIH) of the US National Institutes of Health (grant number R24 AT001293). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This Summary of Findings column series in the European Journal of Integrative Medicine is coordinated and edited by L. Susan Wieland, the Coordinator of the Cochrane Complementary Medicine Field.
Please cite this article in press as: L.S. Wieland, N. Santesso, A Summary of a Cochrane Review: Music for insomnia in adults, Eur. J. Integr. Med. (2016), http://dx.doi.org/10.1016/j.eujim.2016.04.007