Music therapy

The Science of Sound: Unexpected Benefits Of Music Therapy For Dementia

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How the power of music can transform the lives of people living with dementia?

The Science of Sound: Unexpected Benefits Of Music Therapy For Dementia
An Australian study has found an affordable alternative to music therapy for improving the standard of living for those with dementia.

Dementia is the umbrella term used to describe the gradual loss of brain function due to natural changes in the brain structure, which leads to Alzheimer’s disease.

For individuals living with this progressive condition, the gradual erosion of communicating effectively and maintaining social connections presents itself as impaired memory, thinking, and decision-making abilities, often placing a strain on relationships with family and loved ones.

According to the World Health Organization, the number of people living with it is estimated at more than 50 million, and will triple by 2050. No cure exists, but studies have shown the key to effective management could lie in music.

Especially in aged care, the quest for effective, non-pharmacological interventions to enhance the quality of life and cognitive function of patients is ongoing.

Music therapy has a long history, is evidence-based, and offers a unique blend of emotional, cognitive, and social benefits.

Defined by the American Music Therapy Association, music therapy is the clinical use of music interventions to achieve individualized goals within a therapeutic relationship.

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For individuals with Alzheimer’s, these goals often center around cognitive function, memory recall, emotional well-being, and social interaction.

A growing body of research worldwide highlights the success of music therapy in meeting these objectives.

Implementing Harmony: Music Therapy in Practice

The application of music therapy in aged care and Alzheimer’s treatment largely involves personalized music interventions (playing instruments, singing, listening, song writing, and more), tailored to the individual’s history and cognitive abilities. This approach ensures that the therapy is not only effective but also has relevance to the patient.

In facilities and organizations, music therapists work closely with healthcare professionals, caregivers, and families to integrate music therapy into the broader care plan, to offer a coordinated and holistic approach to treatment.

One key study, “Effects of Music Therapy on Patients with Dementia,” published in the National Library of Medicine in 2020, highlights the impact of music therapy with those experiencing early-stage dementia.

The research revealed that music interventions, either with a group or individually, could lead to improvements in cognitive function, mood, and quality of life through active (playing instruments) or passive participation (listening).

The study also notes that music therapy has a long history. The first documented session in the 1800s consisted of musicians performing in patients’ wards. The benefits included a reduction in physical pain and produced a “calming and stimulating” effect.

The Melodic Memory: Music as a Cognitive Enhancer

Other scientific studies have shown that music memories often remain in the brain, even when communication and memories disappear. This is because regions of the brain responsible for musical memory and processing don’t appear to be affected by Alzheimer’s.

The connection between these is extensive and music therapy capitalizes on this connection, making use of familiar melodies and rhythms to stimulate memory recall and cognitive function.

In Alzheimer’s Research & Therapy, March 2023, a study demonstrated that music therapy not only improves the cognitive abilities but also reduces the symptoms of mood like depression in Alzheimer’s patients.

In this evidence-based research, a controlled trial with Alzheimer patients in Europe, China, and the United States was conducted. It compared music therapy with standard care or other non-musical intervention and the evaluation of cognitive functions.

The result? When compared to various control groups, there was a noticeable improvement in cognitive functions following the use of music therapy. This improvement was even more pronounced when patients actively participated in musical activities.

Medicinal Benefits: Emotional and Social Well-Being

Beyond the cognitive improvement, music therapy also offers a multitude of emotional and social benefits.

According to Medical News Today, music therapy has been found to improve the overall well-being of people with Alzheimer’s, their caregivers, and loved ones.

The therapeutic use of music fosters emotional expression, reduces anxiety and agitation, and enhances social interaction among patients. This is particularly valued in aged care settings, where concerns of social isolation and emotional distress is high.

The Future Tune: Advancing Research and Practice

New developments and insights are ongoing, showing how we can reduce the condition of dementia by first addressing factors that affect our brain health. Some of these new developments include blood testing when diagnosing early signs of dementia.

With the current evidence supporting management tools such as the benefits of music therapy, Alzheimer’s care is increasing and this research is key to shedding light on its mechanisms, optimizing intervention strategies, and establishing standardized methods.

Future studies show the continued focus on the long-term effects of music therapy, its impact on disease progression, and its integration with other non-pharmacological interventions.

Music therapy represents a powerful, non-invasive, and cost-effective intervention in the care of individuals with Alzheimer’s, offering significant benefits in cognitive function, emotional well-being, and social interaction.

In Alzheimer’s treatment, it holds one of the foundations to the quality of life for individuals living with this challenging disease.

Music therapy reduces depression, menopausal symptoms

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Women who participated in music therapy had lower levels of depression and reduced menopausal symptoms compared with those who did not, according to findings in Menopause.

“Evidence suggests that the prevalence of depression increases during the menopausal transition and postmenopausal period, including middle age,” DeryaYükselKoçak, PhD, assistant professor in the department of nursing at Hitit University Faculty of Health Sciences in Çorum, Turkey, and colleagues wrote.

Listening to music for 15 minutes every day reduces depression and menopausal symptoms. Source: Adobe Stock.
Listening to music for 15 minutes every day reduces depression and menopausal symptoms. Source: Adobe Stock.

They noted that studies have shown music’s effect on depression and menopausal symptoms separately, though “it is noteworthy that there is no study investigating the effects of … music therapy on [both] menopausal symptoms and the risk of depression in menopausal women.”

Koçak and colleagues enrolled 48 postmenopausal women with no history of depression in a randomized controlled study from July 2019 to December 2020. At the beginning of the study, participants completed a form detailing sociodemographic information, as well as the Menopause Rating Scale (MRS) questionnaire — which assessed somatic, psychological and urogenital symptoms of menopause — and the Beck Depression Inventory (BDI). They completed the MRS and BDI again at the end of 6 weeks.

The researchers played three pieces of Turkish classical music — a genre that had “comforted and calmed” participants in a pilot study — for 21 participants (mean age, 59.1 years; mean age of menopause, 44.2 years). Participants assigned to the music therapy intervention chose their favorite song and were instructed to use headphones to listen to their chosen song for at least 15 minutes every day when they were alone in a quiet environment for 6 weeks. The 27 control participants (mean age, 56.5 years; mean age of menopause, 46.8 years) did not have any intervention.

There were no statistically significant differences in menopausal symptoms between the control and intervention groups at baseline.

MRS posttest scores of the women in the control group were higher than those in the music group, but the difference was not significant, the researchers said.

In the intervention group, MRS posttest scores overall and for three components — somatic, psychological and urogenital subscales — were 99% lower than pretest scores (P < .01), which constituted a significant decrease in menopausal symptoms. There were no significant differences between pretest and posttest median scores in the control group, however.

BDI scores showed depression was significantly decreased in the intervention group (pretest mean value, 15.38; posttest mean value, 11.81; P = .003). In the control group, there was no significant change in BDI scores.

“Although menopause is a natural process, the management of symptoms that occur during this period bears significant importance for women,” Koçak and colleagues wrote.

“The present study on music therapy and depression suggests a significant and permanent reduction in patients’ symptoms and improvement in their quality of life,” they added.

Study limitations included women’s refusal to participate, non-generalizability of findings and self-reported data.

Koçak and colleagues suggested more research on music’s effect on menopausal symptoms to validate their findings for future clinical application.

PERSPECTIVE

BACK TO TOP Stephanie Faubion, MD, MBA)

Stephanie Faubion, MD, MBA

This study highlights the potential benefits of a simple, easy-to-implement, low-cost, low-risk intervention for common symptoms women experience during the menopause transition, including depressed mood. Although this study is small, music therapy can be added to our armamentarium of non-medication strategies for management of menopause symptoms. Additional study is needed to confirm these findings in larger and more diverse groups of women. It is also important to note that for those women who do not experience adequate relief of symptoms with this and other non-medication treatments, there are safe and effective medications for treatment of menopause symptoms, including menopausal hormone therapy.

Stephanie Faubion, MD, MBA

Director, Mayo Clinic Center for Women’s Health

Medical Director, the North American Menopause Society

Music therapy reduces depression, menopausal symptoms

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Women who participated in music therapy had lower levels of depression and reduced menopausal symptoms compared with those who did not, according to findings in Menopause.

“Evidence suggests that the prevalence of depression increases during the menopausal transition and postmenopausal period, including middle age,” DeryaYükselKoçak, PhD, assistant professor in the department of nursing at Hitit University Faculty of Health Sciences in Çorum, Turkey, and colleagues wrote.

Listening to music for 15 minutes every day reduces depression and menopausal symptoms. Source: Adobe Stock.
Listening to music for 15 minutes every day reduces depression and menopausal symptoms. Source: Adobe Stock.

They noted that studies have shown music’s effect on depression and menopausal symptoms separately, though “it is noteworthy that there is no study investigating the effects of … music therapy on [both] menopausal symptoms and the risk of depression in menopausal women.”

Koçak and colleagues enrolled 48 postmenopausal women with no history of depression in a randomized controlled study from July 2019 to December 2020. At the beginning of the study, participants completed a form detailing sociodemographic information, as well as the Menopause Rating Scale (MRS) questionnaire — which assessed somatic, psychological and urogenital symptoms of menopause — and the Beck Depression Inventory (BDI). They completed the MRS and BDI again at the end of 6 weeks.

The researchers played three pieces of Turkish classical music — a genre that had “comforted and calmed” participants in a pilot study — for 21 participants (mean age, 59.1 years; mean age of menopause, 44.2 years). Participants assigned to the music therapy intervention chose their favorite song and were instructed to use headphones to listen to their chosen song for at least 15 minutes every day when they were alone in a quiet environment for 6 weeks. The 27 control participants (mean age, 56.5 years; mean age of menopause, 46.8 years) did not have any intervention.

There were no statistically significant differences in menopausal symptoms between the control and intervention groups at baseline.

MRS posttest scores of the women in the control group were higher than those in the music group, but the difference was not significant, the researchers said.

In the intervention group, MRS posttest scores overall and for three components — somatic, psychological and urogenital subscales — were 99% lower than pretest scores (P < .01), which constituted a significant decrease in menopausal symptoms. There were no significant differences between pretest and posttest median scores in the control group, however.

BDI scores showed depression was significantly decreased in the intervention group (pretest mean value, 15.38; posttest mean value, 11.81; P = .003). In the control group, there was no significant change in BDI scores.

“Although menopause is a natural process, the management of symptoms that occur during this period bears significant importance for women,” Koçak and colleagues wrote.

“The present study on music therapy and depression suggests a significant and permanent reduction in patients’ symptoms and improvement in their quality of life,” they added.

Study limitations included women’s refusal to participate, non-generalizability of findings and self-reported data.

Koçak and colleagues suggested more research on music’s effect on menopausal symptoms to validate their findings for future clinical application.

PERSPECTIVE

Stephanie Faubion, MD, MBA)

Stephanie Faubion, MD, MBA

This study highlights the potential benefits of a simple, easy-to-implement, low-cost, low-risk intervention for common symptoms women experience during the menopause transition, including depressed mood. Although this study is small, music therapy can be added to our armamentarium of non-medication strategies for management of menopause symptoms. Additional study is needed to confirm these findings in larger and more diverse groups of women. It is also important to note that for those women who do not experience adequate relief of symptoms with this and other non-medication treatments, there are safe and effective medications for treatment of menopause symptoms, including menopausal hormone therapy.

Stephanie Faubion, MD, MBA

Director, Mayo Clinic Center for Women’s Health

Medical Director, the North American Menopause Society

Music therapy may help ease depression

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https://speciality.medicaldialogues.in/music-therapy-may-help-ease-depression/

Music therapy benefits COPD patients undergoing pulmonary rehabilitation

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Music can benefit not just your mind, but also your lungs. Music therapy combined with standard pulmonary rehabilitation (PR) improved respiratory symptoms, psychological well-being, and quality of life in patients with chronic obstructive pulmonary disease (COPD) and other chronic respiratory disorders, compared with patients receiving PR alone, the AIR* study showed.

Lead author Mr. Bernardo Canga, a music therapist and researcher from the Louis Armstrong Center for Music and Medicine at Mount Sinai Beth Israel (MSBI) hospital, New York, New York, US, believes music therapy has a huge impact on the quality of care provided.

“Music therapy is cost-effective, has no adverse side effects, and improves communication between patients, families, and medical staff,” Canga said. “Therefore, music therapy has an impressive profile of treatment adherence, which is vital in the recovery process.”

Study participants given music therapy in addition to PR (treatment group) demonstrated fewer depressive symptoms (Least-Square [LS] mean -0.2), compared to control group receiving PR alone (LS mean 1.3, p=0.007).

Health-related Quality of Life (HRQL), as measured by Chronic Respiratory Questionnaire Self-Reported (CRQ-SR), improved in  the treatment group in the four criteria evaluated: dyspnoea (LS mean 0.5, p=0.01), fatigue (LS mean 0.3, p=0.01), emotional function (LS mean 0.3, p=0.005), and mastery (LS mean 0.5, p=0.06), compared with controls. Additionally, music therapy significantly improved perceived dyspnoea in patients, measured by a Dyspnoea Visual Analogue Scale (VAS), especially in week 5 and 6 of the study (p<0.001), compared with controls.

“We hope that our results reinforce a comprehensive foundation for the establishment of music therapy as part of PR care… and [it will become] more commonly used in clinical settings,” said Canga.

A total of 68 participants (mean age 70.1 years), with moderate to severe GOLD stage II-IV lung diseases and other conditions causing chronic airflow limitations, completed the study. Participants were randomly assigned to control group, receiving PR alone, or the treatment group, who received PR plus psycho-music therapy administered by certified music therapists for 6 weeks. The music therapy included live music, visualizations, singing, and wind instrument playing, which incorporated the patients’ preferred music styles.

Canga said allowing patients to choose familiar music encourages self-expression, increases engagement in therapeutic activities, and provides an opportunity to cope with the challenges of a chronic condition.

“Our study is the first to our knowledge that incorporates a multimodal intervention adjunct to standard PR using certified music therapists.”

Expanding on the current study, the Louis Armstrong Center for Music and Medicine is currently using music therapy to enhance the breathing capacity and quality of life of children and teens with asthma under the Asthma Initiative Program. Canga said his team would like to focus on the effect of music therapy intervention specifically on pulmonary function in future study.

Music as Medicine for the Mind

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Music is powerful — it moves us physically and emotionally, often transporting us back to a previous place and time. A foot will start to tap along to a beat or tears begin to well up in response to a touching melody. Far from just stimulating memories surrounding a song, though, many believe music can actually help to preserve and even enhance cognitive function.

Music as Medicine for the Mind

Rhythm of Music and Mind

File this away for small talk or to use as a retort when someone declines your invitation to dance because they “have no rhythm.” Every person — or at least every brain — does have rhythm. This pattern changes depending on the state of activity: increasing when you’re alert and focused and slowing when you’re sleepy.

In certain diseases, like Parkinson’s, the brain rhythm in the circuit controlling movement gets off track. Specific treatments work to restore normal rhythm: deep brain stimulation delivers electrical stimulations and a new device breaks a freezing episode by playing a rhythmic clicking in the ear.

Knowing we all have this inherent rhythm and that we all respond to music somehow, researchers have investigated the brain changes that occur when listening to and playing music. The emotional experience of hearing music can increase the release of dopamine — the brain chemical lacking in Parkinson’s disease. People with musical training have better memory, executive function (planning, problem solving, organizing, etc) and visuospatial perception (ability to determine the relationship of objects in space). While playing music, multiple different areas of the brain are activated and in the long run, this leads to an increase in the volume and activity of the corpus callosum — the bridge that allows communication between the two sides of the brain.

Can Music Mend the Mind?

What if you have no musical background or ability to carry a tune? What if dementia or Parkinson’s disease has already caused cognitive changes or movement difficulties? Can music help?

According to members of the 5th Dementia — an unconventional group of musicians whose only requirements for participation include an interest in music and a diagnosis of Parkinson’s or dementia — that answer is a resounding yes. Their twice-weekly jam sessions have brought about a remarkable transformation in each individual involved. Through the universal language of music, those who have trouble recalling a daily schedule or holding a conversation are able to communicate in a different manner, express their emotions and connect with others on a deeper level.

Irwin Rosenstein, who plays keyboard for the group, describes the music as giving him a purpose so that Parkinson’s and dementia don’t define him. He and his wife Carol founded the 5th Dementia and its parent organization, Music Mends Minds in 2014. Regarding the changes she’s seen in Irwin since then, Carol says “I think he’s much more alert. He’s much more interesting. His cognition has improved… We really were losing a connection, and he was really slipping away. And I can really say that he’s — he’s back again.”

Playing Music Is “a Full Body Workout for the Brain”

Playing music is a complicated undertaking that engages multiple areas of the brain simultaneously. In essence, it’s the definition of multitasking. Translating black and white symbols into pleasing sounds requires:

–          fine motor movements and an intact sensory system to manipulate an instrument,

–          immediate processing of visual and auditory elements of a melody,

–          mathematical precision and internal rhythm to keep tempo,

–          emotional interpretation of the sound, and

–          coordination with other performers.

Playing music exercises the mind and body. It provides a route for social interaction. In drawing someone into its rhythm, it can calm a resting tremor, break a freezing spell and bring gait into a more normal pattern. Music can boost memory, lessen depression, and improve the volume and tone of speech. It’s no wonder some say music is magical.

Make Your Own Music

You don’t have to have any musical training or talent to participate in music therapy. The leader of 5thDementia says there are “no wrong notes” and their website states that the only possible side effect is “happy memories.” Although the 5th Dementia is based in Los Angeles, music therapy is widely available. You can find a music therapist in your area through an online search or talk with your doctor or support group for other recommendations. If no opportunities for formal participation in a band are available, consider singing in the church choir, reaching out to a local music school or picking up your own instrument at home.

HEALTHY SONGS: THE AMAZING POWER OF MUSIC THERAPY

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When I was a child, on most Fridays, my dad, mom, brother and I would travel to Cape Cod to visit my grandparents. For my father, this drive would come after a long day of work, during which he had already commuted from our home, an hour outside of the city, to Boston, where he worked as an accountant, and back home again. He was an intense man, and during these drives to the Cape we were often silent, on edge – unsure how to interpret his sullen and grave demeanor.

After we arrived, my grandmother would typically begin playing a mix of classical music, folk songs and pop songs on her spinet piano – and I would watch my dad’s face transform: his jaw would slacken, while the lines between his eyebrows softened, lifting the intensity of thought that always seemed to burden him.

This was my first experience of the power of music.

Nearly two decades later, I learned of music therapy as a profession. I was a rising junior in college and, without hesitation, I switched my major to learn how to clinically wield music’s ability to transform and heal – a power I had observed years earlier.

Music therapy has grown from relative obscurity to a practice that is becoming fairly mainstream, largely due to the advocacy of colleagues in the field, along with media coverage of the burgeoning profession. Jodi Picoult came to Berklee College to study music therapy to develop the main character – a music therapist – of her novel Sing You Home. Meanwhile, following the gunshot injury she sustained, Representative Gabby Giffords underwent rehabilitation efforts that included music-based interventions. Although she initially couldn’t speak, she could sing, an ability that was used to further her speech recovery. And films about music’s capacity for healing and improving quality of life include the recent releases Alive Inside, The Lady in Apartment 6, Landfill Harmonic and The Music Never Stopped.

Doctor-writer Oliver Sacks’ essay collections, like Musicophilia, introduced stories to the public that explained the ability of music to promote skill learning and/or recovery in the face of severe disability and trauma. Research in neuroscience has backed up many of Sacks’ observations. For example, people who have suffered strokes or have been diagnosed Parkinson’s disease are better able to walk while listening to rhythmic music. In the case of strokes, people who can’t talk can often sing. Singing is then used to facilitate recovery of speech. This has been the case of Representative Gabby Giffords.
Oliver Sacks’ essays – like those in the collection Musicophilia – have helped promote the benefits of music therapy.

Another study showed that premature babies in the neonatal intensive care unit left the ICU, on average, 11 days earlier if they used a device that played lullabies triggered by their sucking. And children who have had orthopedic surgery will report lower levels of pain when doctors offer post-operative music therapy.

In my practice as a speech language pathologist and music therapist, I’m able to use music to serve a variety of patients with an array of needs. Children with autism tend to be more attentive to musical sounds than speech sounds (especially when they’re very young), so I’ll use music to foster their linguistic and cognitive development. In my work with hospice patients, I’ll use quiet music that has a lulling rhythm to help even out their ragged breathing (which is sometimes very difficult for families to watch).

For cancer patients, I’ll use songs of hope and resilience. And by pairing music with imagery, such as relaxing nature images, I’ve helped patients preparing for surgery achieve a state of tranquility that can decrease their need for anesthesia and pain medication. I’ve used the same protocol to decrease the use of anti-anxiety medications among hospice patients I’ve served. Ultimately, carryover is the endgame: we help patients take the tools they’ve learned in music therapy and apply them to their everyday lives.

As a professor of music therapy at the Berklee College of Music, I’m preparing the next generation of music therapists to work in a variety of settings: early intervention programs, public schools, hospice and palliative care, cancer clinics, nursing homes and private practice. For many students, it’s an attractive opportunity – a chance to use their artistry to make the world a better place.

Every week, our Berklee students Skype with a group of child soldiers in Uganda. These young adults have suffered a great deal: forced to kill as children, they often started with their own family members and neighbors. They’ve emerged from the bush traumatized and without purpose. We’re teaching them to use meditative practices in music to calm their minds and to infuse meaning into their lives. As our students share therapeutic practices with the child soldiers, they, in turn, perform and share their music and dance for our students.

It’s this fusion of what many consider two distinct, incompatible entities – art and science – that ultimately elevates both; and the two, as one, can more readily accomplish their shared purpose: the healing and betterment of humanity.

Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory SupportA Randomized Clinical Trial.

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ABSTRACT

Importance  Alternatives to sedative medications, such as music, may alleviate the anxiety associated with ventilatory support.

Objective  To test whether listening to self-initiated patient-directed music (PDM) can reduce anxiety and sedative exposure during ventilatory support in critically ill patients.

Design, Setting, and Patients  Randomized clinical trial that enrolled 373 patients from 12 intensive care units (ICUs) at 5 hospitals in the Minneapolis–St Paul, Minnesota, area receiving acute mechanical ventilatory support for respiratory failure between September 2006 and March 2011. Of the patients included in the study, 86% were white, 52% were female, and the mean (SD) age was 59 (14) years. The patients had a mean (SD) Acute Physiology, Age and Chronic Health Evaluation III score of 63 (21.6) and a mean (SD) of 5.7 (6.4) study days.

Interventions  Self-initiated PDM (n = 126) with preferred selections tailored by a music therapist whenever desired while receiving ventilatory support, self-initiated use of noise-canceling headphones (NCH; n = 122), or usual care (n = 125).

Main Outcomes and Measures  Daily assessments of anxiety (on 100-mm visual analog scale) and 2 aggregate measures of sedative exposure (intensity and frequency).

Results  Patients in the PDM group listened to music for a mean (SD) of 79.8 (126) (median [range], 12 [0-796]) minutes/day. Patients in the NCH group wore the noise-abating headphones for a mean (SD) of 34.0 (89.6) (median [range], 0 [0-916]) minutes/day. The mixed-models analysis showed that at any time point, patients in the PDM group had an anxiety score that was 19.5 points lower (95% CI, −32.2 to −6.8) than patients in the usual care group (P = .003). By the fifth study day, anxiety was reduced by 36.5% in PDM patients. The treatment × time interaction showed that PDM significantly reduced both measures of sedative exposure. Compared with usual care, the PDM group had reduced sedation intensity by −0.18 (95% CI, −0.36 to −0.004) points/day (P = .05) and had reduced frequency by −0.21 (95% CI, −0.37 to −0.05) points/day (P = .01). The PDM group had reduced sedation frequency by −0.18 (95% CI, −0.36 to −0.004) points/day vs the NCH group (P = .04). By the fifth study day, the PDM patients received 2 fewer sedative doses (reduction of 38%) and had a reduction of 36% in sedation intensity.

Conclusions and Relevance  Among ICU patients receiving acute ventilatory support for respiratory failure, PDM resulted in greater reduction in anxiety compared with usual care, but not compared with NCH. Concurrently, PDM resulted in greater reduction in sedation frequency compared with usual care or NCH, and greater reduction in sedation intensity compared with usual care, but not compared with NCH.

Source: JAMA

 

 

Music Therapy in the ICU — Another Way to Lower Sedation Use?

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Awake intensive care unit patients who received music therapy were less anxious than those who did not.

 

Music therapy improves well-being in hospice patients, distracts patients during endoscopy, and helps treat depression in elders. Could it also decrease anxiety in critically ill patients?

Investigators randomized 373 awake and interactive intensive care unit (ICU) patients to one of three groups: patient-directed music through noise-cancelling headphones (with a visit by a music therapist to find preferred music and twice-daily prompts to listen to music), patient-initiated noise-cancelling headphone use only, or usual care. Anxiety was assessed daily with a 100-point visual-analog scale (VAS; range, 0 = “not anxious at all” to 100 = “most anxious ever”), and sedation doses and frequency were analyzed post hoc.

During a mean follow-up of 6 days, daily VAS scores of patients who received patient-directed music were significantly lower (by a mean of 19 points) than those of patients who received usual care; the headphones-alone group scored nonsignificantly lower (by a mean of 8 points) than the usual-care group. Sedation use was somewhat lower in the music-treated group.

Comment: As an editorialist notes, this trial has several limitations, including lack of a standardized sedation protocol and use of an unvalidated anxiety-assessment tool. Despite this, the results suggest that an inexpensive intervention like patient-directed music in the ICU could help limit use of sedating medications and all the complications associated with them.

 

Source: Journal Watch General Medicine