The Effects of Music Intervention on Sleep Quality in Community-Dwelling Elderly
Wang Qun, Chair Sek Ying, Wong Eliza Mi Ling, and Li Xiaomei.
Objectives: To examine the effects of music intervention on sleep quality in community-dwelling elderly people.
Design: Two-armed randomized controlled trial.
Settings: Four urban communities in Xi`an, China.
Participants: People aged 60 years or older with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score >7).
Interventions: All participants received one sleep hygiene education session and biweekly telephone calls. Each participant in the intervention group received an MP3 player with a music database. The participants selected the preferred music and listened for 30–45 minutes per night for 3 months.
Outcome measures: Sleep quality, the main study outcome, was measured by PSQI at baseline, 1 month, 2 months, and 3 months.
Results: Sixty-four elderly people with a mean age of 69.38 ± 5.46 years were randomly assigned to the control group (n = 32) or the intervention group (n = 32). All participants completed the study, and none reported discomfort related to the music intervention. The intervention group demonstrated continuous improvements in sleep quality, with a global PSQI score of 13.53 at baseline, 9.28 at 1 month, 8.28 at 2 months, and 7.28 at 3 months. Although the global PSQI score in the control group also decreased from 12.26 at baseline to 8.72 at 3 months, the intervention group achieved greater improvements at each measurement (all p < 0.05). Repeated-measures analysis of variance revealed significant group-by-time interaction effects in global PSQI score and three component scores: sleep latency, sleep efficiency, and daytime dysfunction (all p < 0.05).
Conclusion: Music is a safe and effective nonpharmacological intervention for improving the sleep quality of community-dwelling elderly people, especially in improving sleep latency, sleep efficiency, and daytime dysfunction.
Source : Journal Alternative and Complementary Medicine
Link to Full Article
Lavender Aromatherapy Improves Sleep Quality in College Students
Lillehei AS, Halcón LL, Savik K, Reis R. Effect of inhaled lavender and sleep hygiene on self-reported sleep issues: A randomized controlled trial. J Altern Complement Med. 2015;21(7):430-438.
Sleep problems are associated with numerous health concerns such as anxiety, depression, cardiovascular disease, hypertension, inflammation, obesity, impaired glucose tolerance, and diabetes. Essential oils, such as lavender (Lavandula angustifolia, Lamiaceae) flower, which have sedative or hypnotic properties, have been evaluated for sleep therapy. The purpose of this randomized, double-blind, placebo-controlled study was to evaluate the effect of inhaled lavender essential oil on sleep quality and quantity in college students.
Students (n = 79, aged 18-36 years) with self-reported sleep issues (difficulty falling asleep, frequent awakenings during the night, or daytime sleepiness) were recruited from the University of Minnesota, Minneapolis, Minnesota, campus. Students were excluded if they were pregnant, working a night shift, or used prescription sleep medication. All subjects received sleep hygiene information based on the National Institutes of Health (NIH) recommendations—specifically, (1) maintain a regular sleep schedule; (2) avoid fluid intake before bed and food, caffeine, alcohol, and nicotine late in the day; (3) create a good sleeping environment (e.g., wear ear plugs and a sleep mask, and avoid screens and texting); (4) create a relaxing bedtime routine; (5) keep up with school work; and (6) exercise regularly.
Each 3-cm adhesive patch contained a 1-cm disc of absorbent material impregnated with 55 µL lavender oil (supplied by Wyndmere Naturals, Inc.; Minnetonka, Minnesota) or left blank (placebo). Based on the gas chromatography-mass spectrometry (GC-MS) analysis provided to the principal investigator, "the essential oil used was chemically consistent with the International Organization for Standardization (ISO) for L. angustifolia."The patch (supplied by Bioesse Technologies, LLC; Minnetonka, Minnesota) had a skin-barrier backing to prevent skin absorption of the essential oil and a time-release function to last 6-8 hours. For 5 consecutive nights, subjects applied a patch on their mid-upper chest at bedtime and removed it in the morning.
Sleep quantity was measured via a Fitbit® tracker (to measure movement during sleep) and sleep diary, and sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance short form. Subjects also completed a sleep hygiene survey (SHS). Assessments were made at baseline, at day 5, and 2 weeks after the completion of treatment.
The majority of the subjects were white (67%) and female (69%); both treatment groups had similar demographics. There were technical issues with the Fitbit, resulting in unacceptable levels of missing data (only 14% of the data were recovered). The patches were reported to have fallen off during sleep in 37% of the person nights (n = 146); however, the data analysis indicated that the patch falling off was not a significant covariate. Based on SHS scores, sleep hygiene was better during the 5-day treatment phase compared to baseline and post-treatment in both groups; there were no significant differences in SHS scores between groups at any time point. Based on the PSQI, both groups had poor sleep before the intervention, and there was no difference between groups at baseline.
Post-treatment, sleep quantity did not significantly differ between groups; both groups had a significant decrease in awakenings (P = 0.02) and increase in being able to fall asleep easily (P = 0.001).
The PSQI and PROMIS assessments indicated that sleep quality was significantly better for the lavender group compared with the sleep hygiene-only group at day 5 (P = 0.01 and P = 0.04, respectively) and at follow-up (P ≤ 0.001 and P = 0.007, respectively). Better sleep hygiene was also associated with better sleep quality but to a much lesser degree at day 5 (P = 0.02 and P = 0.03, respectively) and at follow-up (P = 0.03, PROMIS only). The lavender group had a clinically significant improvement in sleep quality, while there was no clinically significant change in sleep quality in the sleep hygiene-only group. The lavender group had less daytime fatigue at day 5 and follow-up (P = 0.02 and P = 0.009, respectively) and was more likely to wake refreshed at day 5 (P = 0.01). The 4 adverse event reports (minor skin irritation, each lasting 1 night) were attributed to the patch adhesive.
The authors conclude that, in college students with self-reported sleep issues, lavender essential oil inhalation improved sleep quality, and the effect persisted for 2 weeks after lavender aromatherapy was suspended. "The persistent effect of lavender on sleep quality at two-week follow-up suggests a re-balancing or long-acting effect on the sleep cycle, although the exact mechanism of action is unknown." The limitations of the study were the lack of statistical power to evaluate potential differences due to race or ethnicity, the loss of objective Fitbit data regarding sleep quantity, the subjective self-reporting nature of the data, the lack of standardized dosages due to the poor patch adherence, and the potential failure of subject blinding due to the lavender scent. The authors conclude that this trial "supports the use of lavender and sleep hygiene as safe, accessible, and effective interventions for self-reported sleep issues in college students. Further research to study their effect on other populations and additional studies exploring the duration of intervention effects are needed."
—Heather S. Oliff, PhD
Source : American Botanical Council, Herbclip
Link to Source
Alcohol disrupts sleep homeostasis
Alcohol is a potent somnogen and one of the most commonly used “over the counter” sleep aids. In healthy non-alcoholics, acute alcohol decreases sleep latency, consolidates and increases the quality (delta power) and quantity of NREM sleep during the first half of the night. However, sleep is disrupted during the second half. Alcoholics, both during drinking periods and during abstinences, suffer from a multitude of sleep disruptions manifested by profound insomnia, excessive daytime sleepiness, and altered sleep architecture. Furthermore, subjective and objective indicators of sleep disturbances are predictors of relapse. Finally, within the USA, it is estimated that societal costs of alcohol-related sleep disorders exceeds $18 billion. Thus, although alcohol-associated sleep problems have significant economic and clinical consequences, very little is known about how and where alcohol acts to affect sleep. In this review, we have described our attempts to unravel the mechanism of alcohol-induced sleep disruptions. We have conducted a series of experiments using two different species, rats and mice, as animal models. We performed microdialysis, immunohistochemical, pharmacological, sleep deprivation and lesion studies which suggest that the sleep-promoting effects of alcohol may be mediated via alcohol's action on the mediators of sleep homeostasis: adenosine (AD) and the wake-promoting cholinergic neurons of the basal forebrain (BF). Alcohol, via its action on AD uptake, increases extracellular AD resulting in the inhibition of BF wake-promoting neurons. Since binge alcohol consumption is a highly prevalent pattern of alcohol consumption and disrupts sleep, we examined the effects of binge drinking on sleep-wakefulness. Our results suggest that disrupted sleep homeostasis may be the primary cause of sleep disruption observed following binge drinking. Finally, we have also shown that sleep disruptions observed during acute withdrawal, are caused due to impaired sleep homeostasis. In conclusion, we suggest that alcohol may disrupt sleep homeostasis to cause sleep disruptions.
Source : Journal Alcohol
Link to Abstract
Auricular Acupressure Helps Improve Sleep Quality for Severe Insomnia in Maintenance Hemodialysis Patients:A Pilot Study
Yuchi Wu, MS,1,*Chuan Zou, PhD,2,*Xusheng Liu, MS,1Xiuqing Wu, BS,1and Qizhan Lin, MS2
Background:Insomnia is common in patients undergoing maintenance hemodialysis (MHD). Long-term use ofsedative-hypnotic agents is often correlated with increasing adverse effects. Auricular acupressure therapy(AAT) applied to specific auricular acupoints for managing insomnia has achieved favorable outcomes in ahemodialysis unit. This pilot study was performed to demonstrate the potential of AAT for insomnia in MHDpatients and to prepare for a future randomized controlled trial
Methods:Eligible patients were enrolled into this descriptive pilot study and received AAT designed to manage insomnia for 4 weeks. Questionnaires that used the Pittsburgh sleep quality index (PSQI) were completed at baseline, after a 4-week intervention, and 1 month after completion of treatment. Sleep quality and other clinical characteristics, including sleeping pills taken, were statistically compared between different time points.
Results:A total of 22 patients were selected as eligible participants and completed the treatment and questionnaires. The mean global PSQI score was significantly decreased after AAT intervention (p<0.05). Participants reported improved sleep quality (p<0.01), shorter sleep latency (p<0.05), less sleep disturbance(p<0.01), and less daytime dysfunction (p=0.01). They also exhibited less dependency on sleep medications,indicated by the reduction in weekly estazolam consumption from 6.98–4.44 pills to 4.23–2.66 pills(p<0.01). However, these improvements were not preserved 1 month after treatment.
Conclusion:In this single-center pilot study, complementary AAT for MHD patients with severe insomnia wasfeasible and well tolerated and showed encouraging results for sleep quality.
Source : Journal Alternative and Complementary Medicine
Link to Full Article
Sedative Music Facilitates Deep Sleep in Young Adults
Chih-Kuang Chen, MD,1,2 Yu-Cheng Pei, MD, PhD,1,2,3 Ning-Hung Chen, MD,2,4 Li-Ting Huang, MD,1 Shih-Wei Chou, MD, PhD,1,2 Katie P. Wu, MD,1,2 Pei-Chih Ko, MD,1 Alice M.K. Wong, MD,1,3,5 and Chih-Kuan Wu, MD1
1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan/Linkou, Taoyuan, Taiwan.2School of Medicine, Chang Gung University, Taoyuan, Taiwan.3Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.4Division of Pulmonary and Critical Care Medicine, Sleep Center, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan.5Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan.
Objectives: To investigate the effect of sedative music on the different stages of the sleep cycle in young adults with various sleep latencies by using polysomnography (PSG).
Design: Prospective, randomized, controlled, crossover study.
Setting: Sleep center of a teaching hospital.
Participants: Young adults with different sleep latencies. Poor sleepers (Pittsburgh Sleep Quality Index score ≥5) were excluded.
Interventions: Each participant stayed one night in the sleep center for adaptation and on each of the following two nights was assigned to (1) music and (2) control (without music) conditions in random order. In the music condition, sedative music composed by certified music therapists was played on a compact disc player for the first hour the participant was in bed.
Outcome measures: Sleep measures recorded with PSG, including sleep latency and durations of sleep stages.
Results: Twenty-four young adults (mean±standard deviation, 24.5±2.6 years) participated. They were classified into the short sleep latency (SL) group if the baseline SL of the adaptation night was shorter than 10 minutes or into the long SL group if the baseline SL was 10 minutes or longer. Sedative music did not alter the SL in either group. Sedative music reduced stage II sleep in both SL groups (main effect of music, p=0.03; interaction effect, p=0.87) but increased the duration of deep sleep (stages III and IV) only in the long SL group (main effect of music, p=0.15; interaction effect, p=0.02).
Conclusions: In participants with long SL, sedative music improved the quality of sleep by prolonging the duration of deep sleep. This effect provides an alternative and noninvasive way to improve sleep in selected persons experiencing sleep problems.
Source ; Journal Alternative and Complementary Medicine
Link to Full Article