A randomized controlled trial of bedtime music for insomnia disorder

Jespersen, Kira Vibe; Otto, Marit; Kringelbach, Morten L.; Someren, Eus J.W. Van; Vuust, Peter

doi:10.1111/jsr.12817

Cited by 41 publications

(43 citation statements)

References 42 publications

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“…An RCT of 50 self-reported insomniacs found that listening to music before bedtime resulted in shorter stage N2 sleep and longer REM sleep when compared to a control group not exposed to music 15 . However, another study (N = 57) did not find a decrease in the insomnia severity index in a music listening paradigm that lasted for three weeks 16 .…”

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confidence: 90%

The Effects of Presleep Slow Breathing and Music Listening on Polysomnographic Sleep Measures – a pilot trial

Kuula

Halonen

Kajanto

et al. 2020

Sci Rep

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Knowledge on efficient ways to reduce presleep arousal and, therefore, improve sleep, is scanty. We explored the effects of presleep slow breathing and music listening conditions on sleep quality and EEG power spectral density in young adults in a randomized, controlled trial with a crossover design. Participants' (N = 20, 50% females) sleep was measured on two consecutive nights with polysomnography (40 nights), the other night serving as the control condition. The intervention condition was either a 30-minute slow breathing exercise or music listening (music by Max Richter: Sleep). The intervention and control conditions were placed in a random order. We measured heart rate variability prior to, during and after the intervention condition, and found that both interventions increased immediate heart rate variability. Music listening resulted in decreased N2 sleep, increased frontal beta1 power spectral density, and a trend towards increased N3 sleep was detected. In the slow breathing condition higher central delta power during N3 was observed. While some indices pointed to improved sleep quality in both intervention groups, neither condition had robust effects on sleep quality. These explorative findings warrant further replication in different populations. Sleep problems are common in today's society. In a multinational cross-sectional survey, as many as 37% of adults reported sleep complaints, while 35% reported having difficulty initiating and maintaining sleep or non-restorative sleep at least three days per week 1. Given the high prevalence of sleep problems, there is an urgent need for sleep-promoting interventions that can be applied in a self-directed way. Presleep arousal refers to the mental and physiological activation that individuals experience when trying to fall asleep. Presleep arousal may lead to disrupted autonomic nervous system (ANS) activity during sleep 2,3 , and has been shown to mediate the association between higher stress and poorer sleep 4-6. Slow breathing (i.e., breathing at a frequency close to 0.1 Hz) may be a simple way to reduce presleep arousal since it enhance vagal activity 7,8 and increase feelings of relaxation 7,9. Indeed, recent research has demonstrated that slow breathing performed before or at bedtime can improve sleep as measured by polysomnography (PSG). Relative to a baseline measurement, a 20-minute slow breathing session (performed before bedtime at a frequency of 0.1 Hz) was shown to reduce wake after sleep onset (WASO), lower the percentage of N2 sleep, and reduce sleep onset latency (SOL), as well as improve subjective sleep quality in 14 self-reported insomniacs 10. No differences were found between the intervention night and the baseline measurement in a control group consisting of 14 good sleepers. A randomized controlled trial (RCT) (N = 10) found that a single 20-minute biofeedback-assisted slow breathing session before bedtime resulted in an improved score on a sleep disturbance scale (derived from sleep efficiency, rapid eye movement (REM) latency, minut...

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confidence: 90%

The Effects of Presleep Slow Breathing and Music Listening on Polysomnographic Sleep Measures – a pilot trial

Kuula

Halonen

Kajanto

et al. 2020

Sci Rep

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“…The methodology is limited because it does not pinpoint diverse and specific causes of sleep problems. Jespersen et al (2019) suggested that the type of sleep problem (initiation insomnia or maintenance insomnia), severity and persistence of sleep problem (subclinical or clinical insomnia), experimental designs with a risk of bias, sample sizes, and other factors can complicate the legitimacy of study outcomes.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Music on Prescription to Aid Sleep Quality: A Literature Review

Dickson

Schubert

2020

Front. Psychol.

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Research on the efficacy of music for improving sleep quality has produced mixed results. We investigated whether the number of music dosages could be a reason for the lack of clarity. Six longitudinal music sleep studies using the Pittsburgh Sleep Quality Index (PSQI) over 3 weeks were identified. Music when compared to active (audiobooks or medication) or passive controls significantly improved (improvement is reflected by a lower score) PSQI within the first or second week of prescription. The improvement was an average mean difference of −1.15 (SD = 0.53) for each week. Music dosages continued to be associated with improved PSQI over a study that had a 3-month music intervention. One study with a low initial PSQI score resulted in poor sleepers (PSQI > 5) achieving healthy sleep (PSQI < 5) within 3 weeks of regular music intervention. For future studies, "prescribing" music beyond 3 weeks may lead to more instances of healthy sleep, particularly for those who have mild sleep problems. To explain the findings, we proposed that the relationship between weeks of music listening and improved PSQI are attributed to the truncation of poor bedtime habits linked to ruminative tendencies and consequent hyperarousal prior to the music intervention. Music listening at bedtime replaces those bad habits, we argue, by forming a new psychological link between bedtime and sleep through evaluative conditioning. The findings of the present study provide disarming evidence of the potential for prescription of music for treating mild sleep disorder.

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“…In addition, subjects who listened to music had a longer sleep duration, greater sleep efficiency, shorter sleep latency, less sleep disturbance, and less daytime dysfunction as assessed by the Pittsburgh sleep quality index (PSQI) questionnaire (Tan, 2004). Similar results in an assessorblinded randomized controlled trial (RCT) design showed a positive impact on sleep perception and quality of life (Jespersen et al, 2019). In electroencephalography (EEG) studies using time-frequency analysis methods, Kusumandari et al (2018) demonstrated that music stimulation improved sleep quality.…”

Section: Introductionmentioning

confidence: 80%

SWS Brain-Wave Music May Improve the Quality of Sleep: An EEG Study

et al. 2020

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This study investigated the neural mechanisms of brainwave music on sleep quality. Background: Sleep disorders are a common health problem in our society and may result in fatigue, depression, and problems in daytime functioning. Previous studies have shown that brainwave music generated from electroencephalography (EEG) signals could emotionally affect our nervous system and have positive effects on sleep. However, the neural mechanisms of brainwave music on the quality of sleep need to be clarified. Methods: A total of 33 young participants were recruited and randomly divided into three groups. The participants listened to rapid eye movement (REM) brainwave music (Group 1: 13 subjects), slow-wave sleep (SWS) brainwave music (Group 2: 11 subjects), or white noise (WN) (Control Group: 9 subjects) for 20 min before bedtime for 6 days. EEG and other physiological signals were recorded by polysomnography. Results: We found that the sleep efficiency increased in the SWS group but decreased in REM and WN groups. The sleep efficiency in the SWS group was ameliorated [t(10) = −1.943, p = 0.076]. In the EEG power spectral density analysis, the delta power spectral density in the REM group and in the control group increased, while that in the SWS group decreased [F(2,31) = 7.909, p = 0.005]. In the network analysis, the functional connectivity (FC), assessed with Pearson correlation coefficients, showed that the connectivity strength decreased [t(10) = 1.969, p = 0.073] between the left frontal lobe (F3) and left parietal lobe (C3) in the SWS group. In addition, there was a negative correlation between the FC of the left frontal lobe and the left parietal lobe and sleep latency in the SWS group (r = −0.527, p = 0.064). Conclusion: Slow-wave sleep brainwave music may have a positive effect on sleep quality, while REM brainwave music or WN may not have a positive effect. Furthermore, better sleep quality might be caused by a decrease in the power spectral density of the delta band of EEG and an increase in the FC between the left frontal lobe and the left parietal lobe. SWS brainwave music could be a safe and inexpensive method for clinical use if confirmed by more data.

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A randomized controlled trial of bedtime music for insomnia disorder

Cited by 41 publications

References 42 publications

The Effects of Presleep Slow Breathing and Music Listening on Polysomnographic Sleep Measures – a pilot trial

The Effects of Presleep Slow Breathing and Music Listening on Polysomnographic Sleep Measures – a pilot trial

Music on Prescription to Aid Sleep Quality: A Literature Review

SWS Brain-Wave Music May Improve the Quality of Sleep: An EEG Study

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