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Sleep problems are found to be correlated with poor well-being and low quality of life.[1] Persistent sleeping disturbances can lead to fatigue, irritability, and various health issues. Numerous studies have examined the positive impact of music on sleep quality. As early as 2000 B.C., lullabies were designed to aid infant sleep. For adults with sleep-related disorders, music serves as a useful intervention in reducing stress. Approximately 25% of the population facing sleep difficulties regularly use music as a tool for relaxation.[2] This process can be either self-prescribed or under the guidance of a music therapist.

Music therapy is introduced into the medical field for treating sleeping disorders following scientific experimentations and observations. Compared to other pharmacological methods for improving sleep, music has no reported side effects[3] and is easy to administer.[4] In direct comparisons, music has improved sleep quality greater than audiobooks[5][6] and has been comparable to sedative hypnotics.[7] In addition, music can be combined with relaxation techniques such as breathing exercises[8] and progressive muscle relaxation.[9] One review of non-pharmacological sleep aids identified music as the only sleep aid with adequate research.[10] The influence of music on sleep has been investigated across various contexts, exploring how music stimuli can influence different aspects of the sleeping experience. Implications of findings help in building up a more effective procedure of musical therapies to target sleep problems.

A number of companies such as Acoustic Sheep (producer of SleepPhones) and Snoozeband produce headbands that play music to make it easier and more comfortable to listen to music while trying to get to sleep.

Major empirical findings

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Influence on sleep quality

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Research suggests that music contributes to higher perceived sleep quality, greater sleep efficiency, longer sleep durations, less sleep disturbance, and less daytime dysfunction for older adults.[11] This was assessed through improved scores on the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Polysomnography investigations have found listening to slow-tempo music increased slow-wave sleep (deep sleep) and reduced rapid eye movement sleep (lighter sleep stage).[12] Music facilitates a large improvement in sleep quality for insomnia patients.[13] Interventions including music-assisted relaxation and listening to music effectively reduce sleep onset latency for people with insomnia.[14] However, several studies found music to have neither positive nor negative effects on subjective sleep quality for normal individuals.[15][16]

Modulation on heart rate and blood pressure

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Music can reduce sympathetic nervous system activity, decreasing blood pressure and heart rate.[17] The decrease in systolic blood pressure, diastolic blood pressure, and heart rate signal a state of calmness, which is essential for having a good night sleep. Sedative music, which is characterized by a slow tempo, repetitive rhythm, gentle contours, and strings, is effective in generating anxiolytic responses to aid sleep.[18]

Brainwave activity and hormonal responses

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Electroencephalogram (EEG) studies give insights into how music alters brainwave activities during sleep. Gentle and soothing music can lead to increased delta wave activities which indicate deep sleep.[19] Several experiments have tested listening to preferred music significantly decreases cortisol levels and reduces the amount of stress experienced.[20][21] Saliva melatonin, a hormone associated with sleep initiation, was found to be elevated among people using interactive music therapies.[22] These hormones work in attributing a more conducive environment for falling asleep and maintaining stable sleep stages.

Mechanisms

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Dickson & Schubert's RPR

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Dickson & Schubert summarized and evaluated six researcher proposed reasons (RPR) by which music could potentially aid sleep:[23]

  • Entrainment: The synchronization of certain biological processes such as neural activity or heart rate with the rhythmic structure of the music. When the rhythmic pattern of music aligns with the natural rhythm of the body, it is more likely to fall asleep quickly.
  • Masking: Masking involves using music to mitigate the impact of noxious background noises. By listening to music at a comfortable volume, individuals can block those disruptive sounds from outside and create a peaceful sleeping environment.
  • Enjoyment: Listening to preferred, emotionally relatable, or pleasant music can have a positive impact on mood. This induces positive emotions such as happiness, reducing the stress felt to enhance sleep patterns.
  • Distraction: Music acts as a distractor to inner stressful thoughts, by providing a focal point of attention. Individuals focusing on the music itself can divert their attention away from worrying thoughts that are keeping them awake.
  • Expectation: Individuals held the cultural belief that certain types of music can aid their sleep. This belief would act as a placebo effect rather than a direct contributor to sleep quality. They may improve subjective sleeping experience due to the power of suggestions.
  • Relaxation: Music can induce relaxation response by reducing physiological and psychological stress. Slow tempo and calming melodies can reduce heart rate, decrease cortisol level, and alleviate tension. This makes individual easier to fall asleep.

Habit formation

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Dickson & Schubert proposed Habit Formation as an additional RPR under the Arts on Prescription model. Based on classical conditioning, repeated pairing of the music with the intention of sleep can generate a conditioned response. By forming this habit, music alone would be effective in triggering a relaxation response, which signals the body that it is time to sleep. This requires a minimum of three weeks for individuals suffering mild insomnia to become healthy sleepers and continues to improve sleep quality over three months.[24] Music improved sleep quality with increased exposure regardless of differences in the demographic, music genre, duration of treatment, and exposure frequency. Dickson suggests "listening to music that you find relaxing, at the same time, every night for at least three weeks".

Musical genres and features

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Typical genres of music used for sleep (sedative music) include classical music, ethnic music, ambient music, meditation music and lullabies, although researchers have recognised a wide diversity of music genres aiding sleep.[6] The characteristics of music that have improved sleep quality in the music-sleep literature include slow tempo, small change of rhythm, and moderate pitch variation of melody.[16] The selection of music (self selected or researcher selected) does not appear to impact sleep quality.[25]

Instrumental vs Lyrics

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Instrumental music such as sitar or violin is recognized as more effective in inducing sleep than vocal music.[26] Although lyric gives depth and meaning to the music, it also stimulates cognitive processes, making it more difficult to fall asleep. Whereas instrumental music focuses on the melody and rhythm, it allows for relaxation without the distraction of lyrics. Research has given evidence for the use of instrumental music in improving sleep quality.[27]

Nature Sounds and Binaural Beats

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Nature sounds like birdsong or rainfall can provoke a feeling of peacefulness and tranquillity to facilitate sleep.[28] Binaural beats work by presenting two different frequencies to each ear that synchronize brainwave activity. Those two methods can be combined to improve sleep quality by targeting both the sensory experience and brainwave alterations.[29]

Sedative music developed in collaboration with researchers

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Individual variability

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While many studies have shown the significant influence of soft slow music on sleep, it is essential to acknowledge that this effect is not uniform across all individuals. Extensive research has revealed the variability in individual responses to musical stimuli, which can be due to their personal preference, cultural background, and susceptibility to different music types.[32] Some may find classical music entertaining, while others prefer ambient music for relaxation. Cultural background can also shape an individual's perception and response to music stimuli. The concept of music and sleep, although applicable to the general population, needs to take into account these differences to tailor each individual's taste. By customizing music choices, the overall effectiveness of music in improving sleep can be maximized, contributing to a better life quality for people.[33]

See also

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References

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  1. ^ Reimer, Marlene A.; Flemons, W.Ward (2003-04-17). "Quality of life in sleep disorders". Sleep Medicine Reviews. 7 (4): 335–349. doi:10.1053/smrv.2001.0220. ISSN 1087-0792. PMID 14505600.
  2. ^ Morin, C; Leblanc, M; Daley, M; Gregoire, J; Merette, C (2006-02-03). "Epidemiology of insomnia: Prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors". Sleep Medicine. 7 (2): 123–130. doi:10.1016/j.sleep.2005.08.008. PMID 16459140.
  3. ^ Jespersen, Kira V; Pando-Naude, Victor; Koenig, Julian; Jennum, Poul; Vuust, Peter (2022-08-24). Cochrane Developmental, Psychosocial and Learning Problems Group (ed.). "Listening to music for insomnia in adults". Cochrane Database of Systematic Reviews. 2022 (8). doi:10.1002/14651858.CD010459.pub3. PMC 9400393. PMID 36000763.
  4. ^ Jespersen, Kira Vibe; Otto, Marit; Kringelbach, Morten; Van Someren, Eus; Vuust, Peter (2019-01-24). "A randomized controlled trial of bedtime music for insomnia disorder". Journal of Sleep Research. 28 (4). doi:10.1111/jsr.12817. hdl:20.500.11755/87c0091a-31a2-45c9-9f3c-8e65eec815df. ISSN 0962-1105. PMID 30676671.
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  6. ^ a b Jespersen, Kira Vibe; Otto, Marit; Kringelbach, Morten; Van Someren, Eus; Vuust, Peter (August 2019). "A randomized controlled trial of bedtime music for insomnia disorder". Journal of Sleep Research. 28 (4): e12817. doi:10.1111/jsr.12817. hdl:20.500.11755/87c0091a-31a2-45c9-9f3c-8e65eec815df. PMID 30676671. S2CID 59226628.
  7. ^ Deshmukh, Abhijeet D.; Sarvaiya, Avani A.; Seethalakshmi, R.; Nayak, Ajita S. (2009-03-01). "Effect of Indian classical music on quality of sleep in depressed patients: A randomized controlled trial". Nordic Journal of Music Therapy. 18 (1): 70–78. doi:10.1080/08098130802697269. ISSN 0809-8131. S2CID 143923906.
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  15. ^ Koenig, J.; Jarczok, M. N.; Warth, M.; Harmat, L.; Hesse, N.; Jespersen, K. V.; Thayer, J. F.; Hillecke, T. K. (2013-10-01). "Music listening has no positive or negative effects on sleep quality of normal sleepers: Results of a randomized controlled trial". Nordic Journal of Music Therapy. 22 (3): 233–242. doi:10.1080/08098131.2013.783095. ISSN 0809-8131. S2CID 144654998.
  16. ^ a b Cordi, Maren Jasmin; Ackermann, Sandra; Rasch, Björn (2019-06-24). "Effects of Relaxing Music on Healthy Sleep". Scientific Reports. 9 (1): 9079. Bibcode:2019NatSR...9.9079C. doi:10.1038/s41598-019-45608-y. ISSN 2045-2322. PMC 6591240. PMID 31235748.
  17. ^ Loomba, Rohit S.; Arora, Rohit; Shah, Parinda H.; Chandrasekar, Suraj; Molnar, Janos (2012-06-02). "Effects of music on systolic blood pressure, diastolic blood pressure, and heart rate: a meta-analysis". Indian Heart Journal. 64 (3): 309–313. doi:10.1016/s0019-4832(12)60094-7. ISSN 0019-4832. PMC 3860955.
  18. ^ Knight, W. E. J.; Rickard, N. S. (2001-12-01). "Relaxing Music Prevents Stress-Induced Increases in Subjective Anxiety, Systolic Blood Pressure, and Heart Rate in Healthy Males and Females". Journal of Music Therapy. 38 (4): 254–272. doi:10.1093/jmt/38.4.254. ISSN 0022-2917.
  19. ^ Tai, Shao Kuo; Lin, Yu Kai (2018-11-16). "The influence of different kinds of music on brainwave signals". 2018 IEEE International Conference on Advanced Manufacturing (ICAM). IEEE. pp. 223–226. doi:10.1109/amcon.2018.8614971. ISBN 978-1-5386-5609-9.
  20. ^ Helsing, Marie; Västfjäll, Daniel; Bjälkebring, Pär; Juslin, Patrik; Hartig, Terry (2016-10-26). "An Experimental Field Study of the Effects of Listening to Self-selected Music on Emotions, Stress, and Cortisol Levels". Music and Medicine. 8 (4): 187. doi:10.47513/mmd.v8i4.442. ISSN 1943-863X.
  21. ^ KHALFA, STÉPHANIE; BELLA, SIMONE DALLA; ROY, MATHIEU; PERETZ, ISABELLE; LUPIEN, SONIA J. (2006-01-24). "Effects of Relaxing Music on Salivary Cortisol Level after Psychological Stress". Annals of the New York Academy of Sciences. 999 (1): 374–376. doi:10.1196/annals.1284.045. ISSN 0077-8923.
  22. ^ Kim, Jeongmin; Choi, Dain; Yeo, Myung Sun; Yoo, Ga Eul; Kim, Soo Ji; Na, Sungwon (2020-10-12). "Effects of Patient-Directed Interactive Music Therapy on Sleep Quality in Postoperative Elderly Patients: A Randomized-Controlled Trial". Nature and Science of Sleep. 12: 791–800. doi:10.2147/nss.s286375. ISSN 1179-1608. PMC 7585863.
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  24. ^ Dickson, Gaelen Thomas; Schubert, Emery (2020-07-28). "Music on Prescription to Aid SLeep Quality: Literature Review". Frontiers in Psychology. 11: 1695. doi:10.3389/fpsyg.2020.01695. PMC 7399370. PMID 32849025.
  25. ^ Chang, En-Ting; Lai, Hui-Ling; Chen, Pin-Wen; Hsieh, Yuan-Mei; Lee, Li-Hua (2012-08-01). "The effects of music on the sleep quality of adults with chronic insomnia using evidence from polysomnographic and self-reported analysis: A randomized control trial". International Journal of Nursing Studies. 49 (8): 921–930. doi:10.1016/j.ijnurstu.2012.02.019. ISSN 0020-7489. PMID 22494532.
  26. ^ Ragavan, Amritha Varshini; Kaniethapriya, AS; Premananth, P; Anu, S; Anto, J Vijay (2023). "Comparing the Timbre of Different Musical Sounds used in Music Therapy and its Effect on the Quality of Sleep in Medical Students with Insomnia- A Prospective Interventional Study". Journal of Clinical and Diagnostic Research. doi:10.7860/jcdr/2023/58384.17729. ISSN 2249-782X.
  27. ^ Shum, Angela; Taylor, Beverley Joan; Thayala, Jeff; Chan, Moon Fai (2013-11-14). "The effects of sedative music on sleep quality of older community-dwelling adults in Singapore". Complementary Therapies in Medicine. 22 (1): 49–56. doi:10.1016/j.ctim.2013.11.003. ISSN 0965-2299.
  28. ^ Ghezeljeh, TaherehNajafi; Nasari, Maryam; Haghani, Hamid (2018). "Effects of nature sounds on sleep quality among patients hospitalized in coronary care units: A randomized controlled clinical trial". Nursing and Midwifery Studies. 7 (1): 18. doi:10.4103/nms.nms_39_17. ISSN 2322-1488.
  29. ^ Lee, Minji; Song, Chae-Bin; Shin, Gi-Hwan; Lee, Seong-Whan (2019-12-02). "Possible Effect of Binaural Beat Combined With Autonomous Sensory Meridian Response for Inducing Sleep". Frontiers in Human Neuroscience. 13. doi:10.3389/fnhum.2019.00425. ISSN 1662-5161. PMC 6900908.
  30. ^ Dickson, Gaelen Thomas. "Music for Sound Health: Utilising a Theoretical Musical Framework for Invoking Relaxation, Implemented Through a Generative-music Smartphone App." PhD diss., University of Melbourne, Faculty of the Victorian College of the Arts and the Melbourne Conservatorium of Music, Victorian College of the Arts, 2015.
  31. ^ "Pzizz is Clinically Proven to Help You Sleep". pzizz.com. Retrieved 2020-07-11.
  32. ^ Trahan, Tabitha; Durrant, Simon J.; Müllensiefen, Daniel; Williamson, Victoria J. (2018-11-14). "The music that helps people sleep and the reasons they believe it works: A mixed methods analysis of online survey reports". PLOS ONE. 13 (11): e0206531. Bibcode:2018PLoSO..1306531T. doi:10.1371/journal.pone.0206531. ISSN 1932-6203. PMC 6235300. PMID 30427881.
  33. ^ Chan, Moon Fai; Chan, Engle Angela; Mok, Esther (2010-04-30). "Effects of music on depression and sleep quality in elderly people: A randomised controlled trial". Complementary Therapies in Medicine. 18 (3–4): 150–159. doi:10.1016/j.ctim.2010.02.004. ISSN 0965-2299.
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