Skip to main content
. Author manuscript; available in PMC: 2022 Jul 1.
Published in final edited form as: Geriatr Nurs. 2021 Jun 2;42(4):869–879. doi: 10.1016/j.gerinurse.2021.04.014

Table 1:

Characteristics of included studies.

First author, year, country Study design Participants N, mean age±SD Intervention(s) description Music used Intervention Duration Control group Sleep measure(s) Sleep outcomes
Music listening
Chan (2010)32
Hong Kong		 RCT Healthy older adults (60+) N= 42 (IG 21; CG 21) 57.1% age 75+ Listening to an MP3 player + relaxation instructions. Meditative, Chinese classical, western classical, jazz; all were slow, flowing pieces at 60–80 BPM 4 weeks, daily for 30 minutes Uninterrupted rest period PSQI No significant differences between groups.
Huang (2016)39
Taiwan		 Cross-over RCT Sedentary older adults (50+) with chronic insomnia N=38
56.4±6.4 years old

  1. Music listening:Going to sleep after listening to assigned music

  2. Brisk walking exercise with music : walking on a tread mill (velocity = 100/m in; speed = 3.5 mph) two days with lively music

 Three soothing Buddhist songs (Praise Buddha, Song of Praise Sambo, and Namo Shakyamuni Buddha), 60–80 BPM, minor tonalities, smooth melodies. 1 week, 2 days for 30 mins Participants served as their own control EEG+ actigraphy
Sleep quality: VAS

  1. WASO: listening to soothing music before bedtime significantly shortened WASO compared with brisk walking in the evening (p < 0.001).

  2. Subjective sleep quality : No differences between the two conditions.
Innes (2016)22
United States		 RCT Older adults (50+) with subjective cognitive decline or mild cognitive impairment N=60 (KK 30, ML 30)
60.6±1.0

  1. Music listening: Participants were provided a program CD, instruction sheet, and a portable CD player

  2. Kirtan Kriya: Meditation CD with repeating a Kirtan or song, while performing a mudra or physical/motor component and a ‘visualization’.

 Relaxing instrumental music from each of 6 composers:Mozart, Bach, Vivaldi, Beethoven, Pachelbel, and Debussy 12 minutes every day for 12 weeks None PSQI No differences in sleep quality between groups at any time points
Innes (2018)40
United States		 RCT Older adults (50+) with osteoarthritis pain N= 22 (MM 11; ML 11)
58.5±1.4

  1. Music listening: 30–45 min in-person training + illustrated guide, program CD, portable CD player to listen to music at home.

  2. Mantra Meditation: Meditation CD with mantras and additional relaxation instructions

 Relaxing instrumental music from each of 6 composers: Mozart, Bach, Vivaldi, Beethoven, Pachelbel, and Debussy 2 times a day for 15–20 mins for 8 weeks None PSQI Relative to ML, the MM group showed significantly greater improvements in overall sleep quality (p=0.04)
Johns on (2003)41
United States		 Quasi-experimental pre/post one group Older women (70+) with chronic insomnia N=52
80.5		 Music listening: listening to music in bed with an automatic shut-off. Selections varied, participants were asked to choose music in the same category. Participants selected soothing classical music (64%), sacred music (19%) and new age music (17%) 10 days every day, session length not reported None 1. SSS 2. Sleep log: sleep onset, number of awakenings

  1. SSS: significant increase in level of sleepiness at bedtime (t = 3.72, p < 0.01)

  2. Sleep log: significant decrease in sleep onset (t = 3.12, p < 0.01) and number of night time awakenings (t = 2.30, p<0.05)
Lai (2005)38
Taiwan		 RCT Healthy older (60+) adults with poor sleep N=60 (IG 30, CG 30) Music listening: listening to music + standardized relaxation instructions 6 types of sedative music: 5 types western music (synthesizer, harp, piano, orchestra, slow jazz) and 1 type of Chinese music (orchestra folk). Sedative music - 60–80 BPM without accented beats, percussive characteristics or syncopation. 3 weeks, 45 minutes every day Participants were not given music PSQI Sleep quality: significant differences between groups. Compared to CG, sleep quality in IG improved (F(1,60), 86.49; p < 0.01).
Shum (2014)23
Singapore		 RCT Older (55+) adults with poor sleep N=60 (IG 28, CG 32) Music listening: MP4 music player with earphones with constant music genre for the week + additional relaxation instructions. Western classical (Bach, Mozart, Chopin), Chinese classical (Spring river in the moonlight, variation on yang pass), jazz (everlasting, Winter wonderland, in love in vain) and New Age (Shizuku, Lord of wind). All music was soft, instrumental slow music, 60–80 BPM with no lyrics. 40 min session once per week for 6 weeks Asked not to listen to music for 6 weeks PSQI Sleep quality: significant group differences in all weeks between groups. PSQI scores for IG decreased while CG scores remained the same (p values <0.001 – 0.018).
Wahbeh (2019)42
United States		 RCT Older (55+) adults with depressive symptoms N=29 (IG 15, CG 14)

  1. Music listening: iMIN Dr with loaded tracks of favorite music from the selected genres

  2. iRest mediation: iMIN Dr application based on Yiga Nidra mediation techniques which included guided meditations (“Experiencing Yourself as Sensation,” “Peeling Away Tension,” and “The Practice of Gratitude”)

 Favorite music Two-day retreat followed by 6 weeks for at least 20 minutes daily use None PSQI Sleep quality: significant group differences. Sleep quality significantly improved in the iRest mediation group compared to the music listening group (F=4.15, p=0.05)
Wang (2016)21
China		 RCT Older (60+) adults with poor sleep 64 (IG 32, CG 32)
69.4±5.5 (IG 66.9±5.0; CG 69.8±5.6)		 Music listening: instructions to music on an MP3 player + relaxation instructions Chinese instrumental classic, Western classic, natural sounds music, and classical songs without lyrics. All music - soft and sedative with stable melodies at 60–80 BPM 30–45 mins per night for 3 months Sleep hygiene PSQI Compared to the CG, the IG achieved greater improvements in global PSQI score at each time point (p=0.020, 0.012, 0.001); greater improvements in sleep latency (p=0.041), daytime dysfunction (p=0.005); sleep latency (p=0.003); sleep duration (p=0.023), sleep efficiency (p=0.006).
Ziv (2008)30
Israel		 Quasi-experimental pre/post one group Older adults (67+) with insomnia N=15

  1. Muscular relaxation method

  2. Music listening: listening to a music CD or cassette

 Slow melody accompanied by minor harmony all played on piano with background violins and bells that develops for the first 10 mins 40 mins per session for 1 week N/A 1. Actigraphy outcomes: sleep percentage, sleep efficiency, time falling asleep
2. Mini sleep questionnaire and Technion long sleep questionnaire

  1. Actigraphy outcomes: Significant difference between the mean sleep efficiency at base level and sleep efficiency after music relaxation (p=0.022)

  2. Sleep questionnaires : No significant correlations between the subjective measures
Weise (2020)31
Germany		 RCT Nursing home residents (73+) with a diagnosis of dementia N=20 (IG 10, CG 10)
85.1±5.9		 Music listening: Three individualized playlists on MP3 players with headphones. Personally significant music based on own preferences and experiences 30 mins every other day for 4 weeks Wait-list VAS Compared to participants in the CG, participants in the IG had significantly better sleep quality (p=0.038, d=0.52)
Multi-component interventions
Choi (2015)34
Korea		 RCT Healthy women (60+) N=72 (ML+HM 24; HM 25; CG 23)
68% age >66 years old

  1. Music listening + hand massage: participants listened to music using earphones and received hand massage using aroma essential oil.

  2. Hand massage: participants received hand massage using aroma essential oil.

 Popular Korean songs to instrumental performances Four weeks: 5 minutes, twice a week Did not receive hand massage or music Hours of sleep No significant differences between groups
Lai (2015)37
Taiwan		 Cross-over RCT Older adults (50+) with insomnia N=38
59.6±6.7		 Music videos: Seven peaceful religious videos showed nature scenes along with text comprising Buddha’s teaching and words of wisdom while the peaceful music was being played. The musical tempos range from 60 to 85 beats/min (slow), and the music used minor tonalities and smooth melodies to achieve a relaxing effect 30 mins per night for one night Usual care 1. VAS: ease of falling asleep, perceived sleep quality, ease of awakening, daytime function
2. PSG: TST, SE, SOL, WASO, number of awakenings, N1, N2, N3, REM, sleep, arousal index

  1. PSG: Compared with the CG participants in the MV condition had shorter SOL with (Waldχ 2= 9.35; p=.002)

  2. No other significant differences between the MV and usual-care conditions for mean TST, WASO, SE, proportion of sleep spent in N1–N3 and REM stages, number of awakenings, or arousal index

  3. VAS: No significant differences in the reported ease of getting to sleep, perceived quality of sleep, ease of awakening from sleep, or daytime function values.
Rawtaer (2017)35
Singapore		 Quasi-experimental one-group pre/post Older adults (60+) N=189
69.3±5.7		 Combination of tai chi exercise, mindfulness awareness practice, art therapy, music reminiscence therapy Popular evergreen songs 1 to 2 hours for 10 weeks, every 2 weeks for 18 weeks and monthly for the rest of the year N/A PSQI

  1. Sleep disturbance was significantly reduced (baseline, 1.04; postintervention, 0.76; mean difference 0.28; p < 0.01).

  2. No statistically significant changes were detected for the 6 other component scores and the total PSQI score.
Satoh (2015)33
Japan		 RCT Older adults (68+) with probable Alzheimer’s Disease N=20 (CG 10, IG 10)
(IG 78.1±7.0; CG 77.0±6.1)		 Music therapy sessions Favorite music, which was either popular in patients’ youth or very familiar ones of recent years 1 hour per week for 6 months; at home 3x/week for 20 minutes Neuropsychological assessments twice within the 6 month time period Hours slept 2 weeks prior to assessment Sleep time for patients in music therapy group increased from 7.5 hours per night at baseline to 8.2 hours per night post intervention (sleep time was only collected from music therapy group).
Yap (2017)36
Singapore		 RCT Older adults (65+) N= 31 (CG 15, IG 16)
74.7±6.4 (CG 74.9±6.1; IG 74.4±6.8)		 Rhythm-centred music making: group Rhythm Wellness Programme by OneHeart Beat, facilitated by 3 instructors. Rhythmic music using percussion instruments (conga, cowbell, Djembe, Ashiko tan-tans, dunum, shakers, wood blocks). 1 hour per session, once per week for 10 weeks Usual care PSQI No differences in PSQI scores across groups

BPM: beats per minute; CG – control group; EEG: electroencephalogram; HM: hand massage; IG-Intervention group; KK: Kirtan Kriya; ML: music listening; MM: Mantra Meditation; MV: music videos; PDSS-Parkinson’s Disease Sleep Scale; PSG: Polysomnography; PSQI: Pittsburgh Sleep Quality Inventory; RCT: randomized clinical trial; REM: rapid eye movement; RTM: Rest to Music; SE: sleep efficiency; SOL: sleep-onset latency; SSS: Sleepiness- Stanford Sleepiness Scale; TST: Total Sleep Time; TT: Tactile Touch; VAS: visual analog scale; WASO: wake after sleep onset.