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

Abstract

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...

Sleep Quality and Electroencephalogram Delta Power

“…Last, the period of delta change may influence the final results. We found from healthy participants that when the change in delta power occurred in the NREM period, better sleep quality was associated with increased delta power, which was proven in Kuula et al’s (2020) study. They found that participants who received slow breathing training with higher sleep quality had higher delta power during N3, which is a deep sleep stage that lasts approximately 20–40 min.…”

Sleep Well and Recover Faster with Less Pain—A Narrative Review on Sleep in the Perioperative Period

“…In the preoperative evaluation, patients should be advised to maintain the regular circadian sleep–wake rhythm while at the hospital, if possible, and after discharge at home. Non-pharmacological techniques that are likely to improve sleep in both pre- and postoperative settings and which only need short practice include, for example, relaxation techniques, breathing exercises, and listening to music [ 96 , 97 , 98 , 99 ]. The availability of these techniques has significantly increased with the availability of internet-based programs.…”

Updated Review of the Acoustic Modulation of Sleep: Current Perspectives and Emerging Concepts

“…Significant reductions in N2 sleep and a trend towards increased slow-wave sleep were recorded across a whole night. 39 This difference was, however, not reflected in changes in PSQI scores. The small sample size of this pilot study has to be taken into account when interpreting the results.…”

“…19,[33][34][35][36] One other study compared two pieces of music to white noise, 37 and another study compared it to breathing relaxation. 39 In a majority, the intervention took place for 15 to 45 minutes before falling asleep 19,21,30,32-36, while only one study asked subjects to listen to the music for 20 minutes each day for 6 days. 37 Apart from control conditions and exposure time, research has shifted attention towards the potential influence of certain frequencies.…”

“…Other sound specifications, such as volume and tempo, are reported very scarcely and have not been systematically tested. If it was indicated at all in the papers, it was tuned to 42-50 dB 19,21 or self-chosen by the subjects and hence not controlled 24,39 and approximately 50 to 80 bpm. 18 In sum, it remains unclear which frequency or special effect of sound benefits sleep most.…”