Clinical Question

Does music improve sleep quality in older adults?

Bottom Line

This study suggests that listening to music, especially sedative music, can improve sleep quality in older adults, but the underlying data are limited and of mixed quality. (Level of Evidence = 1a−)

Synopsis

The authors searched several databases and registries to identify English- or Chinese-language publications of randomized trials of music to improve sleep in adults 60 years and older. They excluded studies that evaluated people with cognitive dysfunction and those with impaired hearing. The team used the Cochrane Collaboration tool to assess the risk of bias of the included studies, and included five small trials with 288 total patients, all from community settings. The music interventions included a range of live and recorded music, 30 to 60 minutes long, and the intervention periods ranged from two days to three months. The primary outcome measure was the Pittsburgh Sleep Quality Index (point range: 0 to 21; scores higher than 5 indicate poor sleep quality; the minimum clinically important difference is 3.0). The studies were of mixed quality. Music modestly improved sleep quality more than no music (mean difference [MD] = −1.96; 95% CI, −3.23 to −0.69), but there was heterogeneity in the data. Sedative music (e.g., slow tempo, soft volume, smooth melody) was more effective than rhythmic music (MD = −2.35; 95% CI, −3.59 to −1.10 vs. MD = −0.25; 95% CI, −2.23 to 1.73, respectively). Studies that were longer than four weeks found greater improvements than shorter studies (MD = −2.61; 95% CI, −4.72 to −0.50 vs. MD = −2.00; 95% CI, −3.99 to −0.00). On average, none of the studies resulted in clinically important improvements. The authors do not report adverse events.

Study design: Meta-analysis (randomized controlled trials)

Funding source: Self-funded or unfunded

Setting: Various (meta-analysis)

Reference: Chen C, Tung H, Fang C, et al. Effect of music therapy on improving sleep quality in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2021;69(7):1925–1932.