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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., (© 2024 The Author(s). Journal of Midwifery & Women's Health published by Wiley Periodicals LLC on behalf of American College of Nurse Midwives (ACNM).)

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.

Background: Disorders of consciousness (DOC), i.e., unresponsive wakefulness syndrome (UWS) or vegetative state (VS) and minimally conscious state (MCS), are conditions that can arise from severe brain injury, inducing widespread functional changes. Given the damaging implications resulting from these conditions, there is an increasing need for rehabilitation treatments aimed at enhancing the level of consciousness, the quality of life, and creating new recovery perspectives for the patients. Music may represent an additional rehabilitative tool in contexts where cognition and language are severely compromised, such as among DOC patients. A further type of rehabilitation strategies for DOC patients consists of Non-Invasive Brain Stimulation techniques (NIBS), including transcranial electrical stimulation (tES), affecting neural excitability and promoting brain plasticity., Objective: We here propose a novel rehabilitation protocol for DOC patients that combines music-based intervention and NIBS in neurological patients. The main objectives are (i) to assess the residual neuroplastic processes in DOC patients exposed to music, (ii) to determine the putative neural modulation and the clinical outcome in DOC patients of non-pharmacological strategies, i.e., tES(control condition), and music stimulation, and (iii) to evaluate the putative positive impact of this intervention on caregiver's burden and psychological distress., Methods: This is a randomised cross-over trial in which a total of 30 participants will be randomly allocated to one of three different combinations of conditions: (i) Music only, (ii) tES only (control condition), (iii) Music + tES. The music intervention will consist of listening to an individually tailored playlist including familiar and self-relevant music together with fixed songs; concerning NIBS, tES will be applied for 20 minutes every day, 5 times a week, for two weeks. After these stimulations two weeks of placebo treatments will follow, with sham stimulation combined with noise for other two weeks. The primary outcomes will be clinical, i.e., based on the differences in the scores obtained on the neuropsychological tests, such as Coma Recovery Scale-Revised, and neurophysiological measures as EEG, collected pre-intervention, post-intervention and post-placebo., Discussion: This study proposes a novel rehabilitation protocol for patients with DOC including a combined intervention of music and NIBS. Considering the need for rigorous longitudinal randomised controlled trials for people with severe brain injury disease, the results of this study will be highly informative for highlighting and implementing the putative beneficial role of music and NIBS in rehabilitation treatments., Trial Registration: ClinicalTrials.gov identifier: NCT05706831, registered on January 30, 2023., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Spaccavento et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Sleep is often severely disturbed in hospitalized patients due to multiple factors such as noise, pain, and an unfamiliar environment. Since sleep is important for patient recovery, safe strategies to improve sleep in hospitalized patients are warranted. Music interventions have been found to improve sleep in general, and the aim of this systematic review is to assess the effect of music on sleep among hospitalized patients. We searched 5 databases to identify randomized controlled trials evaluating the effect of music interventions on sleep in hospitalized patients. Ten studies including a total of 726 patients matched the inclusion criteria. The sample sizes ranged from 28 to 222 participants per study. The music interventions varied in how the music was chosen as well as duration and time of day. However, in most studies, participants in the intervention group listened to soft music for 30 minutes in the evening. Our meta-analysis showed that music improved sleep quality compared to standard treatment (standardized mean difference 1.55 [95% CI 0.29-2.81], z = 2.41; p = 0.0159). Few studies reported other sleep parameters, and only one study used polysomnography for objective sleep measurement. No adverse events were reported in any of the trials. Hence, music may constitute a safe and low-cost adjunctive intervention to improve sleep in hospitalized patients. Prospero registration number: CRD42021278654., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Women often report more anxiety than men, but there are divergent results regarding the putative correlation between physiological variables, such as cortisol, blood pressure and heart rate and the experienced emotional states. The aim of the present study was to evaluate sex differences in anxiety, and the relation to serum cortisol, blood pressure and heart rate. We used data from two pooled studies with participants from the same population ( N  = 405) facing a real-life stressor, bronchoscopy, as part of examination for lung cancer. At admission, blood pressure and heart rate were recorded, and a blood sample was taken for analysis of serum cortisol. Participants then completed Spielberger's State Trait Anxiety Inventory (STAI). Patients had elevated anxiety measured with STAI state compared to relevant age and sex stratified norm scores. Women had significantly higher STAI state score than men ( M  = 44.9, SD = 13.2 vs M  = 36.2, SD = 10.7; t (403) = 7.25, p  < 0.001). Mean serum cortisol, systolic blood pressure and heart rate showed no significant sex difference. There was a weak but significant correlation between state anxiety and heart rate and cortisol but none between blood pressure and anxiety. This study adds an important confirmation of sex differences in anxiety in a real-life setting, where women report significantly more anxiety than men do. However, the physiological markers only show a weak link with experienced anxiety, and exhibit no sex differences.

Throughout history, lullabies have been used to help children sleep, and today, with the increasing accessibility of recorded music, many people report listening to music as a tool to improve sleep. Nevertheless, we know very little about this common human habit. In this study, we elucidated the characteristics of music associated with sleep by extracting audio features from a large number of tracks (N = 225,626) retrieved from sleep playlists at the global streaming platform Spotify. Compared to music in general, we found that sleep music was softer and slower; it was more often instrumental (i.e. without lyrics) and played on acoustic instruments. Yet, a large amount of variation was present in sleep music, which clustered into six distinct subgroups. Strikingly, three of the subgroups included popular tracks that were faster, louder, and more energetic than average sleep music. The findings reveal previously unknown aspects of the audio features of sleep music and highlight the individual variation in the choice of music used for sleep. By using digital traces, we were able to determine the universal and subgroup characteristics of sleep music in a unique, global dataset, advancing our understanding of how humans use music to regulate their behaviour in everyday life., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Scarratt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Insomnia is a common problem in modern society. It is associated with reduced quality of life and impairments in physical and mental health. Listening to music is widely used as a sleep aid, but it remains unclear if it can actually improve insomnia in adults. This Cochrane Review is an update of a review published in 2015., Objectives: To assess the effects of listening to music on sleep in adults with insomnia and to assess the influence of specific variables that may moderate the effect., Search Methods: For this update, we searched CENTRAL, MEDLINE, Embase, nine other databases and two trials registers up to December 2021. In addition, we handsearched reference lists of included studies, and contacted authors of published studies to identify additional studies eligible for inclusion, including any unpublished or ongoing trials., Selection Criteria: Randomised controlled trials comparing the effects of listening to music with no treatment or treatment as usual (TAU) in adults complaining of sleep difficulties., Data Collection and Analysis: Two review authors independently screened records for eligibility, selected studies for inclusion, extracted data and assessed risk of bias of the included studies. We assessed the certainty of the evidence using GRADE. The primary outcomes were sleep quality, insomnia severity, sleep-onset latency, total sleep time, sleep interruption, sleep efficiency and adverse events. Data on the predefined outcome measures were included in meta-analyses when consistently reported by at least two studies that were homogeneous in terms of participants, interventions and outcomes. We undertook meta-analyses using random-effects models., Main Results: We included 13 studies (eight studies new to this update) comprising 1007 participants. The studies examined the effect of listening to prerecorded music daily, for 25 to 60 minutes, for a period of three days to three months. The risk of bias within the studies varied, with all studies being at high risk of performance bias, because of limited possibilities to blind participants to the music intervention. Some studies were at high risk of detection bias or other bias. Four studies reported funding from national research councils, three studies reported financial support from university sources and one study reported a grant from a private foundation. Five studies did not report any financial support. At the end of the intervention, we found moderate-certainty evidence for improved sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI) in themusic groups compared to no intervention or TAU (mean difference (MD) -2.79, 95% confidence interval (CI) -3.86 to -1.72; 10 studies, 708 participants). The PSQI scale ranges from 0 to 21 with higher scores indicating poorer sleep. The size of the effect indicates an increase in sleep quality of the size of about one standard deviation in favour of the intervention. We found no clear evidence of a difference in the effects of listening to music compared to no treatment or TAU on insomnia severity (MD -6.96, 95% CI -15.21 to 1.28; 2 studies, 63 participants; very low-certainty evidence). We found low-certainty evidence that, compared to no treatment or TAU, listening to music may reduce problems with sleep-onset latency (MD -0.60, 95% CI -0.83 to -0.37; 3 studies, 197 participants), total sleep time (MD -0.69, 95% CI -1.16 to -0.23; 3 studies, 197 participants) and sleep efficiency (MD -0.96, 95% CI -1.38 to -0.54; 3 studies, 197 participants), but may have no effect on perceived sleep interruption (MD -0.53, 95% CI -1.47 to 0.40; 3 studies, 197 participants). In addition, three studies (136 participants) included objective measures of sleep-onset latency, total sleep time, sleep efficiency and sleep interruption and showed that listening to music may not improve these outcomes compared to no treatment or TAU. None of the included studies reported any adverse events., Authors' Conclusions: The findings of this review provide evidence that music may be effective for improving subjective sleep quality in adults with symptoms of insomnia. More research is needed to establish the effect of listening to music on other aspects of sleep as well as the daytime consequences of insomnia., (Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)

Insomnia Disorder is the most prevalent sleep disorder, and it involves both sleep difficulties and daytime complaints. The neural underpinnings of Insomnia Disorder are poorly understood. Several existing neuroimaging studies focused on local measures and specific regions of interests, which makes it difficult to judge their whole-brain significance. We therefore here applied a data-driven approach to assess differences in whole-brain structural connectivity between adults with Insomnia Disorder and matched controls without sleep complaints. We used diffusion tensor imaging and probabilistic tractography to assess whole-brain structural connectivity, and examined group differences using network-based statistics. The results revealed a significant difference in the structural connectivity of the two groups (p = .014). Participants with Insomnia Disorder showed reduced connectivity in a sub-network that included mainly fronto-subcortical connections with the insula as a key region. By taking a whole-brain network perspective, our study enables the integration of previous inconsistent findings. Our results reveal that reduced structural connectivity of the left insula and the connections between frontal and subcortical regions are central neurobiological features of Insomnia Disorder. The importance of these areas for interoception, emotional processing, stress responses and the generation of slow-wave sleep may help guide the development of neurobiology-based models of the prevalent condition of Insomnia Disorder., (© 2019 European Sleep Research Society.)

Music is often used as a self-help tool to alleviate insomnia. To evaluate the effect of bedtime music listening as a strategy for improving insomnia, we conducted an assessor-blinded randomized controlled trial. Fifty-seven persons with insomnia disorder were included and randomized to music intervention (n = 19), audiobook control (n = 19) or a waitlist control group (n = 19). The primary outcome measure was the Insomnia Severity Index. In addition, we used polysomnography and actigraphy to evaluate objective measures of sleep, and assessed sleep quality and quality of life. The results showed no clear effect of music on insomnia symptoms as the group × time interaction only approached significance (effect size = 0.71, p = .06), though there was a significant improvement in insomnia severity within the music group. With regard to the secondary outcomes, we found a significant effect of the music intervention on perceived sleep improvement and quality of life, but no changes in the objective measures of sleep. In conclusion, music listening at bedtime appears to have a positive impact on sleep perception and quality of life, but no clear effect on insomnia severity. Music is safe and easy to administer, but further research is needed to assess the effect of music on different insomnia subtypes, and as an adjunctive or preventive intervention., (© 2019 European Sleep Research Society.)

Objectives: Music may be a valuable and low-cost coping strategy for cancer patients. We conducted a systematic review and meta-analysis to identify the psychological and physical effects of music interventions in cancer treatment., Methods: We included randomized, controlled trials with adult patients in active cancer treatment exposed to different music interventions versus control conditions. Qualitative studies and systematic reviews were excluded. We identified a total of 2624 records through 2 systematic searches (June 2015 and September 2016) in PubMed, Scopus, EMBASE, Cinahl, Web of Science, Cochrane, and PsycINFO and used Risk of Bias Assessment, GRADE and Checklist for Reporting Music-Based Interventions to evaluate the music applied and quality of the studies. We conducted meta-analyses using Review Manager (version 5.3). PROSPERO reg. no. CRD42015026024., Results: We included 25 RCT's (N = 1784) of which 20 were eligible for the meta-analysis (N = 1565). Music reduced anxiety (SMD -0·80 [95% CI, -1.35 to -0.25]), pain (SMD -0.88 [95% CI -1.45 to -0.32]), and improved mood (SMD -0.55 [95% CI, -0.98 to -0.13]). However, studies were hampered by heterogeneity with I 2 varying between 54% and 96%. Quality of the studies ranged from very low to low. The most effective mode of music intervention appeared to be passive listening to self-selected, recorded music in a single session design., Conclusions: Music may be a tool in reducing anxiety, pain, and improving mood among patients with cancer in active treatment. However, methodological limitations in the studies conducted so far prevent firm conclusions., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Insomnia is a common sleep disorder in modern society. It causes reduced quality of life and is associated with impairments in physical and mental health. Listening to music is widely used as a sleep aid, but it remains unclear if it can actually improve insomnia in adults., Objectives: To assess the effects of listening to music on insomnia in adults and to assess the influence of specific variables that may moderate the effect., Search Methods: We searched CENTRAL, PubMed, Embase, nine other databases and two trials registers in May 2015. In addition, we handsearched specific music therapy journals, reference lists of included studies, and contacted authors of published studies to identify additional studies eligible for inclusion, including any unpublished or ongoing trials., Selection Criteria: Randomised controlled trials and quasi-randomised controlled trials that compared the effects of listening to music with no treatment or treatment-as-usual on sleep improvement in adults with insomnia., Data Collection and Analysis: Two authors independently screened abstracts, selected studies, assessed risk of bias, and extracted data from all studies eligible for inclusion. Data on pre-defined outcome measures were subjected to meta-analyses when consistently reported by at least two studies. We undertook meta-analyses using both fixed-effect and random-effects models. Heterogeneity across included studies was assessed using the I² statistic., Main Results: We included six studies comprising a total of 314 participants. The studies examined the effect of listening to pre-recorded music daily, for 25 to 60 minutes, for a period of three days to five weeks.Based on the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach, we judged the evidence from five studies that measured the effect of music listening on sleep quality to be of moderate quality. We judged the evidence from one study that examined other aspects of sleep (see below) to be of low quality. We downgraded the quality of the evidence mainly because of limitations in design or being the only published study. As regards risk of bias, most studies were at high risk of bias on at least one domain: one study was at high risk of selection bias and one was judged to be at unclear risk; six studies were at high risk of performance bias; three studies were at high risk of detection bias; one study was at high risk of attrition bias and was study was judged to be at unclear risk; two studies were judged to be at unclear risk of reporting bias; and four studies were at high risk of other bias.Five studies (N = 264) reporting on sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) were included in the meta-analysis. The results of a random-effects meta-analysis revealed an effect in favour of music listening (mean difference (MD) -2.80; 95% confidence interval (CI) -3.42 to -2.17; Z = 8.77, P < 0.00001; moderate-quality evidence). The size of the effect indicates an increase in sleep quality of the size of about one standard deviation in favour of the intervention compared to no treatment or treatment-as-usual.Only one study (N = 50; low-quality evidence) reported data on sleep onset latency, total sleep time, sleep interruption, and sleep efficiency. However, It found no evidence to suggest that the intervention benefited these outcomes. None of the included studies reported any adverse events., Authors' Conclusions: The findings of this review provide evidence that music may be effective for improving subjective sleep quality in adults with insomnia symptoms. The intervention is safe and easy to administer. More research is needed to establish the effect of listening to music on other aspects of sleep as well as the daytime consequences of insomnia.

Background: Traumatized refugees often suffer from severe sleep problems, with serious consequences in physiological and psychological areas of functioning. Recent research suggests that music may be a viable intervention to improve sleep quality., Objective: The aim of this pilot study was to investigate whether sleep quality of traumatized refugees could be improved by listening to relaxation music at bedtime, and whether such an improvement would affect the experience of trauma symptoms and well-being., Methods: This study used a two-group pretest/posttest design with repeated measures taken for sleep quality. Dependent variables included sleep quality measured by the Pittsburgh Sleep Quality Index, trauma symptoms as measured by the PTSD-8 and well-being measured by the "How Do You Feel?" questionnaire designed specifically for refugees. Fifteen traumatized refugees with sleep problems participated in the study. The intervention group received the music listening condition (relaxing music played at night through a music player nested in an ergonomic pillow); the control group received only the ergonomic pillow., Results: Statistical comparisons showed a significant improvement of sleep quality in the music group, but not in the control group. A significant increase in well-being was found only in the intervention group, but there were no changes in trauma symptoms in either of the groups., Conclusions: These results support the use of relaxation music listening at bedtime to improve sleep quality in traumatized refugees.